Chronic changes on Imaging Test

Chronic changes on an imaging test implies that the finding being discussed by the radiologist is something that has been there for a long time. This implies that the radiologist either sees this finding on multiple prior imaging tests or that it has a chronic appearance.

Chronic changes or abnormalities on imaging tests are common and less likely to be abnormal or responsible for the symptoms.  Acute findings are more likely to be new and responsible for the symptoms.  Acute findings are also new compared to prior similar imaging tests.

Examples of chronic findings

In the bones, an example of a chronic finding may be something like arthritis which has been present for a long time.  A broken bone which has healed.  A bone fragment from prior trauma.  Changes from prior surgery on the bones.  A tumor of bone which has not changed may be chronic.

In the abdomen, chronic findings may be calcifications in the liver or spleen from prior infection.  Lymph nodes which have not changed over time.  Calcifications of the arteries from atherosclerosis.  A lesion in an organ which has not changed over time.  Prior infarcts of organs like the spleen.

In the brain, chronic changes can be from a prior stroke or other injury.  This causes loss of brain tissue called encephalomalacia.  Calcifications in the brain are usually chronic and can be from prior infections or represent normal anatomy, like in the pineal gland.

Chronic changes in the chest can be calcified lymph nodes from old infection.   You can have scarring in the lungs from old insults like pneumonia or progressive scarring from disease.  Chronic changes can include nodules or spots in he lungs from old sites of infection.

Chronic changes are therefore findings in the body which have been around for a long time.  Many times they are not significant or responsible for the symptoms.  The radiologist will indicate when he feels the chronic findings are significant and provide a diagnosis.

Chronic findings may be worked up the same way as acute findings.  We can order more testing like additional imaging tests. In some cases, chronic findings may need to be biopsied to determine the diagnosis.  The radiologist will play an important role in determining the significance of chronic findings.