Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cholecystography


Related Terms

  • Biliary Tract Disorder Diagnosis
  • Cholecystographies

Specialists

  • Gastroenterologist
  • General Surgeon
  • Internal Medicine Physician
  • Radiologist

Comorbid Conditions

Factors Influencing Duration

Allergic reaction or other side effects in response to ingestion of contrast medium may influence the length of disability. The underlying cause for the procedure may also be a factor. If gallstones, gallbladder disease, or cystic duct disease are discovered, further medical and / or surgical treatments may be necessary. The results of the test may necessitate further treatment and disability duration may be lengthened.

Medical Codes

ICD-9-CM:
87.59 - Other Biliary Tract X-ray; Cholecystography

Overview

Cholecystography is a procedure in which x-rays are used to visualize the gallbladder following ingestion of a radiopaque dye. The dye is ingested with a high-fat meal at noon on the day before the test, and it becomes concentrated in the gallbladder. The next day, x-ray images of the gallbladder are taken.

Cholecystography was used in the past to evaluate individuals who had symptoms suggestive of gallbladder disease, such as pain in the upper right part of their abdomen (upper right epigastric pain) and / or intolerance of fatty foods. For the most part, cholecystography has been replaced by ultrasound which is simple, safe, quick, does not involve exposure to ionizing radiation, and allows examination of structures adjacent to the gallbladder. In rare cases where the gallbladder is contracted and full of stones, identification with ultrasound is not feasible and cholecystography may be necessary. Cholecystography can also determine if the cystic duct is open (patency) and whether the contractility of the gallbladder is normal, which are important factors if medical dissolution of the stones or lithotripsy is under consideration.

Stones (calculi) that have formed in the gallbladder may pass into the common bile duct where they can obstruct the flow of bile into the small intestine (duodenum). The presence of calculi in the bile ducts is referred to as choledocholithiasis.

A normal gallbladder will appear pear-shaped with smooth, thin walls. Its size may vary; however, the basic structure is outlined clearly on x-ray film. Gallstones will be visible on the film as negative shadows that can change position within the gallbladder. Other abnormalities (such as polyps or tumors) will be fixed in one position. If the gallbladder fails to "light up" on x-ray, it may indicate a form of gallbladder inflammatory disease (cholecystitis). Failure of the gallbladder to contract following stimulation by fat ingestion may also indicate cholecystitis or obstruction of the common bile duct.

Source: Medical Disability Advisor



Reason for Procedure

Cholecystography is used in special circumstances to visualize the anatomy of the gallbladder in individuals who have gallstones (cholelithiasis), gallbladder disease, or cystic duct disease.

Source: Medical Disability Advisor



How Procedure is Performed

On the day before the procedure is performed, the individual ingests a high-fat meal at noon and a fat-free meal in the evening. Two to 3 hours after the evening meal, a radiopaque contrast medium (iopanoic acid) is ingested in tablet form. All other food and fluids except water are restricted until completion of the test. On the day of the test, an enema may be administered. The individual lies face down (prone position) on a hard, flat (radiographic) table and x-ray films are taken of the gallbladder. The individual then lies on the left side (left lateral decubitus position), and then stands erect while more x-ray images are taken. The individual may then be given a high-fat meal or synthetic fat-containing agent to stimulate gallbladder emptying. X-rays are taken 15 and 30 minutes following the fat stimulus in order to visualize the bile duct. Films may also be taken at 60 minutes if the gallbladder empties slowly. Normal food intake can be resumed after the test is completed.

Source: Medical Disability Advisor



Prognosis

Cholecystography has a low sensitivity and is neither highly sensitive nor highly specific for diagnosing diseases of the gallbladder. For the most part, it has been replaced by ultrasound examination. However, in difficult diagnostic situations it may be used to supplement plain film x-rays and ultrasound examination.

Source: Medical Disability Advisor



Complications

A complication of cholecystography may include an allergic reaction to the radiopaque contrast medium or diarrhea.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

There should not be any limitations at work following cholangiography unless unforeseen complications, such as an allergic reaction, occur during the test. In this case, additional recovery time at home may be required.

Source: Medical Disability Advisor



References

General

Grainger, Ronald G. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. Philadelphia: W.B. Saunders, 2001.

Horton, J. D., and L. Bilhartz. "Gallstone Disease and its Complications." Sleisenger & Fordtran's Gastrointestinal and Liver Disease. Eds. M. Feldman, L. S. Friedman, and M. H. Sleisenger. 7th ed. Philadelphia: W.B. Saunders, 2002.

Source: Medical Disability Advisor






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