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Is Infiltrate a Useful Term in the Interpretation of Chest Radiographs? Physician Survey Results¹

¹ From the Departments of Pediatrics (H.S.P.) and Radiology (D.N.S.), Walter Reed Army Medical Center, 16000 Georgia Ave, Washington, DC 20307. Received June 24, 2002; revision requested August 22; final revision received May 31, 2004; accepted June 23. Address correspondence to H.S.P. (e-mail: harlan.patterson@na.amedd.army.mil).

PURPOSE: To determine how physicians interpret the word infiltrate when it is used in a chest radiography report and if the word is helpful in the clinical management of patients.

MATERIALS AND METHODS: Informed consent from participants was not required, and the study protocol was granted exempt status. One hundred sixty-five questionnaires were distributed, in conjunction with various physician meetings, at three separate nonaffiliated training hospitals. In the three-question survey, respondents were asked the definition of infiltrate, whether the term is helpful in guiding patient therapy, and whether it implies an etiology. The respondent demographic data obtained included date of graduation from medical school, amount of postgraduate training completed, primary or training specialty, and board or sub-board qualification.

RESULTS: There were 151 physician respondents, 94 (62.3%) of whom were house staff members. One hundred fifteen (76%) responders chose bacterial pneumonia as a condition consistent with infiltrate. One hundred thirty (86.1%) respondents replied that infiltrate implied more than one pathophysiologic condition. Eighty-two (54.3%) of those surveyed thought infiltrate could mean any of six or more different pathophysiologic conditions, including nonspecific pneumonia, interstitial pneumonia, viral pneumonia, consolidation, or nonspecific interstitial process. The number of terms selected did not vary according to level of residency training (P = .23); however, there was a significant specialty-related difference in the number of terms selected (P = .018). Internists selected a median of 10 terms, while others selected a median of six. Only 54 (36%) respondents thought that the term infiltrate was helpful in patient care, and only five (3%) thought that the term implied an etiology.

CONCLUSION: Infiltrate is a nonspecific and imprecise term when it is used as a radiograph descriptor, and use of this term does not usually enhance patient care.

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