Incidentalomas in Chest Radiograph of Apparently Healthy Individuals Presenting for Pre-Employment Medical Examination in Enugu State, Nigeria

Abstract

Background: A chest radiograph is the most commonly requested and performed imaging for diagnosis and screening including medical examination. Aim: The study aimed to determine the prevalence and pattern of incidentalomas in radiographs of cases presenting for pre-employment medical examination. Methods: This was a retrospective review of chest radiographs conducted for patients presenting for pre-employment medical examination from January to December 2022. Relevant data including sociodemographic characteristics, clinical details and chest radiograph reports were retrieved using study proforma from all patients with complete medical data were analyzed using statistical package for social sciences (SPSS) version 23 with the level of statistical significance set as P <0.05 taken as statistically significant. Results: Three hundred and eleven chest radiographs of subjects aged 20–49 years were evaluated, of which 22 (7.1%) incidentalomas were found. Most were females (55%). Of these incidentalomas, 12 (54.6%) were in the cardiovascular system, while the skeletal and pulmonary systems accounted for eight (36.4%) and two (9.1%), respectively. In all participants, clinically significant findings were eight (2, 6%), comprising of cardiomegaly five (1.6%), leash of vessels in the upper zone one (0.3%), blunt costophrenic angle one (0.3%), and right-sided aortic arch one (0.3%). Age and gender have no statistical significance in the incidental findings. Conclusion: Although the incidence of clinically significant incidentalomas appears low in our environment where beliefs and lack of adequate healthcare financing prevent the majority from seeking timely medical attention, chest radiograph remains an invaluable tool for pre-employment medical examination. Some underlying medical conditions could be picked up, further investigation sought to save life, and it serves as a baseline with which future findings may be compared.