Patient Evaluation

  • Keith C. Meyer
  • Ganesh Raghu


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.


Interstitial lung disease Idiopathic interstitial pneumonia Idiopathic pulmonary fibrosis HRCT Bronchoalveolar lavage Lung biopsy 

Further Reading

  1. ATS/ERS. International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir and Crit Care Med. 2002;165:277–304.Google Scholar
  2. 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
  3. Raghu G, Brown KK. Interstitial lung disease: clinical evaluation and keys to an accurate diagnosis. Clin Chest Med. 2004;25:409–19.PubMedCrossRefGoogle Scholar
  4. Meyer KC. The role of bronchoalveolar lavage in interstitial lung disease. Clin Chest Med. 2004;25:637–49.PubMedCrossRefGoogle Scholar
  5. Strange C, Highland KB. Interstitial lung disease in the patient who has connective tissue disease. Clin Chest Med. 2004;25:549–59.PubMedCrossRefGoogle Scholar
  6. 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
  7. Judson MA. The diagnosis of sarcoidosis. Clin Chest Med. 2008;29:415–27.PubMedCrossRefGoogle Scholar
  8. Polomis D, Runo J, Meyer KC. Pulmonary hypertension in interstitial lung disease. Curr Opin Pulm Med. 2008;14:462–9.PubMedCrossRefGoogle Scholar
  9. Flaherty KR, King Jr TE, Raghu G, et al. Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis? Am J Respir Crit Care Med. 2004;170:904–10.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Medicine, Section of Allergy, Pulmonary and Critical Care MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.Department of Medicine & Lab Medicine (Adjunct), Division of Pulmonary & Critical Care Medicine, Interstitial Lung Disease, Sarcoid and Pulmonary Fibrosis Program, Lung Transplant ProgramUniversity of WashingtonSeattleUSA

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