A chest x-ray is the cornerstone of diagnosis in occupational lung disease. Findings on an x-ray suggestive of occupational lung disease include pleural thickening, pleural plaques, pleural abnormalities, calcification, small or large opacities, costophrenic angle obliteration, atelectasis, pneumothorax, parenchymal bands, enlarged hilar or mediastinal lymph nodes, bullae, and granulomata.

• A chest x-ray is the cornerstone of diagnosis in occupational lung disease. Findings on an x-ray suggestive of occupational lung disease include:^[1]
  • Pleural thickening
  • Pleural plaques
  • Pleural abnormalities
  • Calcification
  • Small or large opacities
  • Costophrenic angle obliteration
  • Atelectasis
  • Pneumothorax
  • Parenchymal bands
  • Enlarged hilar or mediastinal lymph nodes
  • Bullae
  • Granulomata

• An x-ray may be helpful in the diagnosis of complications of occupational lung disease, which include:
  • Pulmonary edema
  • Pneumothorax
  • Pleural effusion

X-ray findings depending on specific etiologies of occupational lung disease include:^{[2][3][4][5][6][7]}

• Multiple, small rounded opacities
• Predilection to dorsal aspect of upper lobe
• Diffuse ground glass opacities
• Punctuate calcification in lymph nodes

• Small, irregular opacities coalesce to indicate progressive massive fibrosis

• Predilection to lower lobes
• Diaphragmatic plaques are pathognomonic
• Fine and coarse linear, peripheral, reticular opacities

• Multiple, rounded opacities with or without calcification
• Architectural distortion
• Loss of lung tissue volume
• Shadows
• Upper lobe predominance
• Chronic berylliosis shows emphysema with bulla formation

• Starts at the lower lobes and moves progressively upwards
• Reticular opacities with honeycombing

• Nodular opacities
• Lobar consolidation
• Upper lobe scarring
• Conglomerate shadows
• Lung destruction

• Small nodules
• Reticular opacities
• Small cystic spaces
• Basal predominance