In medical or research imaging, an incidental imaging finding (also called an incidentaloma) is an unanticipated finding which is not related to the original diagnostic inquiry. As with other types of incidental medical findings, they may represent a diagnostic, ethical, and philosophical dilemma because their significance is unclear. While some coincidental findings may lead to beneficial diagnoses, others may lead to overdiagnosis that results in unnecessary testing and treatment, sometimes called the "cascade effect".Incidental findings are common in imaging. For instance, around 1 in every 3 cardiac MRIs result in an incidental finding. Incidence is similar for chest CT scans (~30%).As the use of medical imaging increases, the number of incidental findings also increases. Adrenal
Incidental adrenal masses on imaging are common (0.6 to 1.3% of all abdominal CT). Differential diagnosis include adenoma, myelolipoma, cyst, lipoma, pheochromocytoma, adrenal cancer, metastatic cancer, hyperplasia, and tuberculosis. Some of these lesions are easily identified by radiographic appearance; however, it is often adenoma vs. cancer/metastasis that is most difficult to distinguish. Thus, clinical guidelines have been developed to aid in diagnosis and decision-making. Although adrenal incidentalomas are common, they are not commonly cancerous - less than 1% of all adrenal incidentalomas are malignant.The first considerations are size and radiographic appearance of the mass. Suspicious adrenal masses or those ≥4 cm are recommended for complete removal by adrenalectomy. Masses <4 cm may also be recommended for removal if they are found to be hormonally active, but are otherwise recommended for observation. All adrenal masses should receive hormonal evaluation.
Atenolol/chlorthalidone, also known as co-tenidone, is a combination medication used to treat high blood pressure. It is made up of atenolol, a beta-blocker and chlortalidone, a diuretic. It is not recommended as an initial treatment but may be used in those who are taking atenolol and chlortalidone individually. It is taken by mouth.Common side effects include gastrointestinal upset and gout. Serious side effects may include liver problems, pancreatitis, and psychosis. Use is not recommended during pregnancy. Use during breastfeeding may harm the baby. Atenolol works by blocking β1-adrenergic receptors in the heart, thus decreasing the heart rate and workload. Chlorthalidone works by increasing the amount of sodium lost by the kidneys.The combination was approved for medical use in the United States in 1984. It is available as a generic medication. In 2017, it was the 295th most commonly prescribed medication in the United States, with more than one million prescriptions. References
External links
"Atenolol mixture with chlorthalidone". Drug Information Portal. U.S. National Library of Medicine.