Complete General Guideline Principles for Granulomatous
Diseases for workers compensation patientsOrthopedics

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Other Granulomatous Diseases.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Other Granulomatous Diseases of Occupational Interstitial Lung Disease

Chronic immunological and foreign-body reactions to antigens in the lungs, which may include metal dusts, are the causes of ILD and are also referred to as pneumoconiosis
Prominent examples include:

  • Beryllium (Beryllium Disease)

  • Cobalt in cemented tungsten carbide (Hard Metal Disease)

  • Work-related Sarcoidosis.

Condition Considerations of Granulomatous Diseases

Overall, the clinical symptoms of hard metal sickness are comparable to those of other pneumoconiosis. Hard metal disease pathology is consistent with giant cell interstitial pneumonia. In a malfunctioning foreign body reaction, interstitial fibrosis is accompanied by active macrophages that fill alveoli.

Chronic beryllium disease is a systemic granulomatous inflammatory disorder that is very similar to sarcoidosis. The tissue response is mediated by immune mechanisms and may not localize to an area of dust accumulation. This may manifest in systemic, body-wise disease manifestations, although less frequently than in sarcoidosis.

Latency of Granulomatous Diseases

These illnesses are rare, and different people experience issues at various exposure levels. Before these illnesses show clinical symptoms, years may pass, and there are different clinical presentations.

Condition Considerations of Granulomatous Diseases

  • An inhalation injury from an irritant typically causes this illness (e.g., diffuse alveolar injury related to nitrogen oxides).

  • It is important to distinguish between diffuse interstitial fibrosis and more prevalent idiopathic interstitial fibrosis, often known as “usual interstitial pneumonia” or “nonspecific interstitial pneumonia.”

  • Direct management is ineffective for treating extensive fibrosis, which may develop after recovery from diffuse alveolar damage brought on by toxic inhalation.

  • Diffuse interstitial fibrosis’ clinical appearance may be identical to advanced stages of all occupational ILDs.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.

We are orthopedic surgeons and do not treat chest diseases. We will refer you to someone in your area who does treat respiratory symptoms.


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Dr. Nakul Karkare

I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.