How is idiopathic pulmonary fibrosis (IPF) diagnosed?
Idiopathic pulmonary fibrosis (IPF) can be difficult to diagnose since many lung diseases can cause breathlessness and cough, and some of these other diseases can have similar symptoms and X-ray results. You may have to see more than one specialist, including a respirologist, to help with the diagnosis.
Your doctor will ask you questions about your home and work environments, your smoking history and your medical history. This will help them determine whether there were any environmental, occupational, genetic, or other factors that could be linked to the development of pulmonary fibrosis.
Your doctor will do a physical examination of your lungs and will also examine other parts of your body including your heart, joints, fingernails, skin and muscles.
Although no single test can diagnose IPF, your doctor may recommend a number of different tests including:
Pulmonary function test (PFT): A PFT, or breathing test, is a simple test to measure how much air you can blow in and out of your lungs and how well your lungs can absorb oxygen.
Six-minute walk test: This test helps determine your physical fitness, as well as the amount of oxygen in your blood at rest and with physical activity.
Chest x-ray: Chest X-rays are simple images that can screen for interstitial lung disease and can sometimes be useful to help monitor progression.
Blood tests: A number of blood tests can be requested to help identify other causes of interstitial lung disease.
Computed tomography (CT scan): These radiology images will determine whether there is scarring in your lungs and will help identify the subtype of interstitial lung disease.
Bronchoscopy: Bronchoscopy is a procedure that involves inserting a small flexible tube, called bronchoscope, through your mouth or nose and into your lungs. This is not necessary for diagnosis but some patients with possible IPF undergo this procedure to help identify the presence of infection or to suggest other subtypes of interstitial lung disease.
Surgical lung biopsy: Patients with an unclear diagnosis will sometimes undergo a surgical lung biopsy performed by a surgeon under general anesthetic. This test involves small incisions in the side of the chest, which allows removal of lung tissue and its examination under a microscope.