Core IM | Internal Medicine Podcast
#170 ILD and High-Risk Medication Prescribing: Gray Matters Segment
Feb 5, 2025
Rob Palowell, a pulmonologist from Massachusetts General Hospital, and Kelly Graham, a primary care physician at Beth Israel Deaconess Medical Center, delve deep into interstitial lung disease (ILD). They discuss the challenges of diagnosing incidental lung findings and the nuances between antifibrotics and immunosuppression. The conversation also highlights the complexities of patient care, especially when social barriers hinder treatment. Both emphasize a holistic approach, addressing patients' basic needs alongside their medical conditions for better care outcomes.
34:59
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Quick takeaways
- Differentiating between incidental CT findings is critical for accurate diagnosis and tailored treatment strategies in interstitial lung disease.
- Addressing socioeconomic factors and health literacy is essential to improve patient compliance and ensure safe engagement with healthcare.
Deep dives
Addressing Incidental Findings in Lung Imaging
Incidental findings, such as interstitial changes on a CT scan, may indicate early stages of interstitial lung disease (ILD) or other conditions like atelectasis. Differentiating between these possibilities is crucial, and a specialized ILD-protocol CT scan can provide more clarity through distinct imaging techniques, including supine and prone positioning. This approach helps determine whether observed changes are genuine fibrotic alterations or simply a result of body positioning during imaging. If fibrosis is suspected, further pulmonary evaluation is warranted, although the urgency may depend on the patient's symptoms and overall health status.
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