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Illicit Drug Use, Pulmonary Manifestations
Tyler H. Ternes, MD; Carol C. Wu, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Spectrum of pulmonary complications related to use of inhaled or intravenous (IV) illicit drugs
                • Typical drugs: Heroin, cocaine ("crack"), methamphetamine ("speed"), codeine, methadone, methylphenidate (Ritalin)
              • Excipient: Insoluble filler materials that bind active drug, and contribute to shape and lubrication for improved oral ingestion
                • Talc, cellulose, crospovidone, starch

            IMAGING

            • Imaging Features

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          DIAGNOSTIC CHECKLIST

                          • Consider

                            Selected References

                            1. Almeida RR et al: Frequency and reliability of the reversed halo sign in patients with septic pulmonary embolism due to IV substance use disorder. AJR Am J Roentgenol. 214(1):59-67, 2020
                            2. Blinick R et al: Cracking the opium den: cardiothoracic manifestations of drug abuse. J Thorac Imaging. 36(2):W16-31, 2020
                            3. Nguyen VT et al: Pulmonary effects of i.v. injection of crushed oral tablets: "excipient lung disease". AJR Am J Roentgenol. 203(5):W506-15, 2014
                            4. Nguyen ET et al: Pulmonary complications of illicit drug use: differential diagnosis based on CT findings. J Thorac Imaging. 22(2):199-206, 2007
                            5. Gotway MB et al: Thoracic complications of illicit drug use: an organ system approach. Radiographics. 22 Spec No:S119-35, 2002
                            Related Anatomy
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                            Related Differential Diagnoses
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                            References
                            Tables

                            Tables

                            KEY FACTS

                            • Terminology

                              • Imaging

                                • Top Differential Diagnoses

                                  • Clinical Issues

                                    • Diagnostic Checklist

                                      TERMINOLOGY

                                      • Definitions

                                        • Spectrum of pulmonary complications related to use of inhaled or intravenous (IV) illicit drugs
                                          • Typical drugs: Heroin, cocaine ("crack"), methamphetamine ("speed"), codeine, methadone, methylphenidate (Ritalin)
                                        • Excipient: Insoluble filler materials that bind active drug, and contribute to shape and lubrication for improved oral ingestion
                                          • Talc, cellulose, crospovidone, starch

                                      IMAGING

                                      • Imaging Features

                                        • Imaging Recommendations

                                          DIFFERENTIAL DIAGNOSIS

                                            PATHOLOGY

                                            • General Features

                                              CLINICAL ISSUES

                                              • Presentation

                                                • Demographics

                                                  • Natural History & Prognosis

                                                    DIAGNOSTIC CHECKLIST

                                                    • Consider

                                                      Selected References

                                                      1. Almeida RR et al: Frequency and reliability of the reversed halo sign in patients with septic pulmonary embolism due to IV substance use disorder. AJR Am J Roentgenol. 214(1):59-67, 2020
                                                      2. Blinick R et al: Cracking the opium den: cardiothoracic manifestations of drug abuse. J Thorac Imaging. 36(2):W16-31, 2020
                                                      3. Nguyen VT et al: Pulmonary effects of i.v. injection of crushed oral tablets: "excipient lung disease". AJR Am J Roentgenol. 203(5):W506-15, 2014
                                                      4. Nguyen ET et al: Pulmonary complications of illicit drug use: differential diagnosis based on CT findings. J Thorac Imaging. 22(2):199-206, 2007
                                                      5. Gotway MB et al: Thoracic complications of illicit drug use: an organ system approach. Radiographics. 22 Spec No:S119-35, 2002