I- Introduction :

1- Definition : opacity micronodular whose diameter is 1.5 or 3 mm can be localized or diffuse, with reticular images or reticulonodular.

2- Circumstances of discovery : respiratory symptoms or during a general disease.

II- positive Dgc :

radiological

III- dgc differential :

False images of miliary :

• Error-Technique : Apnea, old cliche, expiration will increase the images reticular nodular.
• Obesity, pregnancy.

IV- etiological Dgc :

Requires a careful balance, whether clinical, radiological, breathing pattern, or even lung biopsy.

1- infectious miliary :

– Tuberculosis.
– bacterial miliary : staph : flaky appearance.
– sepsis Table.
– virose : nodule.
– Miliaire mycosique : may calcify.
– Pneumocystose carinii.
– At the ID (page), rapidly changing, cardiorespiratory failure.
– Sd de Loffler (dry rate, hyper eosinophilia, images labile).

2- mechanical miliary :

– lung heart : edema, IVG, RM reticular nodular ( the bases are more infused the top).
+ TRT : digitalis diuretics, RM (auscultation).
– hemosiderosis ( secondary to RM : ATED de RM, -OAP repeated sub ->picture miliary.
– Granita post hemoptoic.

3- Miliary malignancies :

– Lymphangite carcinomateuse.
– Ostéosarcome : blood-borne invasion and lymphogenic follows the hematogenous
– kc secondary image.

• miliary.
• Opacity single round.
• multiple opacity round.
• Opacity-miliary carcinomatosis.
• ADP.
• Lymphangite.
• Pleurale.

– Kc to be, the,
– Kc stomach, pancreas, larynx and bronchi.
– Carcinose miliaire : image balloon release.
– Hodgkin's disease are associated ADP.

V- To behave :

1- acute table : miliary with acute table.

– Pneumo hospitalization or Rea.
– general acute miliary

• febrile => TBC.
• Pa02, saturation, dyspnea.
• Criteria gravity : respiratory, cardiovascular
• Clinique.
• for clinique.
• 02therapy.

– Among young adults : miliary tuberculosis
– Assessment of extension
– Fundus : THIS.
– PL in the second position.
– Blood culture.
– FNS .

2- cold miliary : (chronicity).

• miliary fever or respiratory distress.
• Fistula ADP often.

3- miliary tuberculosis :

• Adult : widespread : secondary kc
• localized : infectious, bacterial or viral.

4- miliary + ADP mediastinal :

• TBC
• Sarcoïdose
• Hodgkin

5- miliary + abnormal cardiac silhouette :

• RM, IVG

6- miliary + professional context :

• silicone.
• asbestosis.
• allergic alveolitis (Lung farmer and breeder birds).

7- Miliary highly radiopaque especially scanner :

• Miliaire TBC calcifiée.
• idiopathic hemosiderosis.
• Cracinose secondary kc, ostéosarcome.
• Micro alveolar lithiasis.

IF NOT DGC DOSE : DISCUSS THE LUNG BIOPSY.