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The diagnosis of idiopathic pulmonary fibrosis (IPF) typically involves questioning about medical history and examinations to classify the condition and eliminate other possible conditions.
There are several other lung diseases that have similar symptoms to IPF, which can make the diagnosis of the condition more difficult. In most cases, the involvement of a respiratory specialist is needed to confirm the diagnosis.
It is important to establish a thorough understanding of the patient’s overall health and specific factors that may be associated with IPF. The initial consultation should involve a series of questions to establish the presenting symptoms and any related factors that may affect the diagnosis.
In particular, relevant questions about smoking history, exposure to triggers and concurrent health conditions are usually addressed. Characteristic symptoms that patients may report include shortness of breath and dry cough.
There are a few simple examinations that can be carried out immediately in a general medical practice, to gain a better understanding of the symptoms and health condition at hand.
A stethoscope can be used to listen to the sound of breathing in the lungs, as a crackling sound can be suggestive of fibrosis. Additionally, thickening of tissue ate the base of fingers and toenails, known as digital clubbing may indicate the involvement of IPF.
Pulmonary function tests are designed to assess the function of the lungs, including the passage of air in and out, the total capacity and the ability to transfer oxygen into the blood. There are various different machines that can be used to collect this information and assist in the diagnosis of IPF.
Oximetry is a simple test that measures the oxygen saturation of the blood, serving as an indicator of the effectiveness of the lung function. An exercise stress test may also be used to monitor lung function during physical activity and establish abnormalities.
Additionally, diagnostic imaging techniques are often needed to investigate the cause of abnormalities noted in the consultation and physical examination.
A chest X-ray is useful to detect abnormalities in the structure of the lung and differentiate IPF from other similar conditions of the respiratory system. It is more difficult to visualize the lungs on an X-ray than bones, but the technique can still be helpful in the diagnostic process. Computerized tomography (CT) scans can be used when a clearer image with greater detail is required.
In general, the presence of a honeycomb effect in the lung tissue often reflects scarring in the area and is indicative of fibrosis.
In some cases, further testing is required to investigate the symptoms and cause of the condition, which may include a bronchoscopy.
This technique involves the insertion of a thin tube with a miniature lens through the nasal passage and into the lungs, which allows the internal tissues of the lungs to be visualized and check for any abnormalities. In most cases, this procedure is conducted under local anesthetic to reduce irritation in the throat.
Video-assisted thoracoscopic surgery (VATS) is a technique used to obtain a biopsy of the lung tissue, which may be required to eliminate other conditions in the diagnostic process.
This is usually carried out under general anesthetic and involves a number of small incisions and the insertion of an endoscope into the lungs, which can be used to take the biopsy.