The clinical evaluation of a patient with suspected interstitial lung disease (ILD) plays a key role in successfully making a confident clinical diagnosis. A secure diagnosis may be made with minimal radiologic imaging in some instances, but clinicians often need to obtain high-resolution computed tomography of the thorax (HRCT), lung specimens obtained via bronchoscopy, and, if needed, surgical lung biopsy and other appropriate testing. A well-performed patient interview and physical examination can provide key information that can assist in making a confident diagnosis when combined with appropriate laboratory testing, imaging, and/or specimens from invasive procedures. This chapter will outline an approach to the clinical evaluation of patients who undergo evaluation for possible ILD.
KeywordsInterstitial lung disease Idiopathic interstitial pneumonia Idiopathic pulmonary fibrosis HRCT Bronchoalveolar lavage Lung biopsy
- ATS/ERS. International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir and Crit Care Med. 2002;165:277–304.Google Scholar
- Schwarz MI, King Jr TE, Raghu G. Approach to the evaluation and diagnosis of interstitial lung disease. In: Schwarz MI, King Jr TE, editors. Interstitial lung disease. 4th ed. Hamilton: BC Decker; 2003. p. 1–30.Google Scholar
- Neralla S, Meyer KC. The keys to the diagnosis of interstitial lung disease. J Respir Dis. 2005;26:372–8 (part 1), 443–8 (part 2), 466–78 (part 3).Google Scholar