Value of the lateral view in diagnosing pleural plaques

Our plain-English summary of Value of the lateral view in diagnosing pleural plaques, by G. Hillerdal (Archives of Environmental Health, 1986).

The study

• Author: G. Hillerdal
• Journal: Archives of Environmental Health
• Published: 1986;41(6):391-2
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001162).

Abstract

To assess the value of the lateral view in the diagnosis of pleural plaques, 2018 chest roentgenograms from the general population were scrutinized for such plaques. The lateral and posterior-anterior (PA) views were read separately and without knowledge of the occupational history or other clinical data. Of the males, 4.8% had pleural plaques in the PA view and 2% had dorsal pleural plaques in the lateral view. A total of 54% of the positive cases in the PA view also showed dorsal plaques in the lateral view, while 69% of those with dorsal plaques also showed typical plaques in the PA view. Thus, there remained a number of cases which were diagnosed only in the lateral view; in all, these constituted 18.8%.

In plain English

This short report asked how much a side (lateral) chest X-ray adds to the standard back-to-front (posterior-anterior, PA) view in finding pleural plaques. The author used small-size chest X-rays of everyone born in 1920, taken within 5 years of a general health survey. Of 2,018 people screened, 15 PA and 171 lateral views were discarded for technical reasons. The examiner did not know clinical data, including asbestos exposure, and read all PA views before the lateral views. On the PA view, 48 males (4.8%) and 5 females (0.5%) had plaques. Of these 53, 25 also showed plaques on the lateral view. Thirty-six lateral views showed dorsal (back-wall) plaques. Of the 11 with lateral-only plaques, 4 men had changes that might be early plaques when their PA films were re-examined. In all, 64 people were counted as having plaques; 11 of them had plaques seen only on the lateral view. The author, calling this a small study, concluded that adding the lateral view raises diagnosed plaques by almost 20% and that it should be used routinely.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Short report: X-ray reading study comparing PA and lateral chest views, read separately and blind
• Who was studied: Small-size chest X-rays of all persons born in 1920, taken within 5 years of a general health survey; 2,018 persons screened. 15 PA views and 171 lateral views were discarded for technical reasons. The text does not state where the population lived.
• Exposure: Asbestos exposure was not studied. The examiner did not know the clinical data, including asbestos exposure. No fiber types are named.
• Main results:
  • On the PA view, 48 males (4.8%) and 5 females (0.5%) showed pleural plaques
  • Of the 53 people with plaques on the PA view, 25 also showed typical plaques on the lateral view; in 7 the lateral view was discarded
  • 36 lateral views showed dorsal pleural plaques; 25 of these also had typical frontal plaques
  • Of the remaining 11 with plaques on the lateral view only, 4 (all males) had pleural changes that might be early plaques when their frontal views were re-examined
  • In all, 64 persons were plaque carriers; in 11 of them plaques were diagnosed only on the lateral view. The article prints this as 19%, but 11 of 64 works out to about 17%.
• The authors' conclusion: The author concluded, describing this as a small study, that the number of diagnosed pleural plaques increases by almost 20% if the lateral view is also considered, and that the lateral view should be used routinely in all investigations.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Occupational History.

Related studies

• Physician-based ultrasound-guided biopsy for diagnosing pleural disease — R.J. Hallifax, J.P. Corcoran, et al. (2014)
• Multiple pleural plaques. II — H.C. Anton (1968)
• A systematic review of the association between pleural plaques and changes in lung function — L. Kopylev, K.Y. Christensen, et al. (2015)
• Comment on "A systematic review of the association between pleural plaques and changes in lung function" by Kopylev et al (2014) — J.E. Goodman, L.E. Kerper, et al. (2015)
• Authors' response: A systematic review of the association between pleural plaques and changes in lung function — L. Kopylev, K.Y. Christensen, et al. (2015)
• Aetiology of pleural plaques — V. Rous, J. Studený (1970)

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