In order to diagnose your IPF, your specialist will ask about your breathing problems, perform a physical examination, and order a number of tests.
These results are discussed in a multi-disciplinary team meeting (MDT or MDM). Your specialist will discuss these results with you to provide you with the most accurate information about your lung disease and the best treatment options available.
Your specialist will ask you about the following:
- Your symptoms – cough and breathlessness
- Your occupations, particularly jobs where you may have been exposed to asbestos, wood or stone dust, metals
- Your hobbies and pets
- If you have ever smoked
- A family history of lung disease
- Details of prescribed and over-the-counter medications
- Your health in general
Your doctor will perform a physical examination and you may have a number of tests:
In people with IPF, the scarring usually starts in the lower part of the lungs and leads to a reduction in lung volume.
Computed tomography (CT) scan of the chest
A CT scan provides a highly detailed picture of the lungs. In IPF, the typical pattern of fibrosis is described as UIP and comprises reticulation (fine lines) and honeycombing (clusters of small cysts). However, approximately 20-30% of people with IPF do not have these typical CT appearances and may require additional investigations, such as bronchoscopy or lung biopsy, to make a confident diagnosis of IPF.
Lung or pulmonary function (breathing) tests. These tests measure your lung capacity (forced vital capacity or FVC) and how efficiently the lungs transfer gases to and from the blood (gas transfer or TLco/DLco).
Assessment of oxygen saturation
A pulse oximeter on your finger will measure your oxygen saturation at rest and with exercise, such as during a 6 minute walk test or shuttle test.
This is an ultrasound scan that assesses the function of the heart. In particular, it is used to look for increased pressure on the right side of the heart, which is called pulmonary hypertension.
This procedure samples the cells within the lungs. A small camera (bronchoscope) is passed either through the nose or mouth into the lungs. It is performed with local anaesthetic and a sedative, usually as a day case procedure.
In some circumstances, a biopsy of the lung is required. This is performed under genral anaesthetic by a thoracic surgeon who uses by a keyhole method called video assisted thorascopic surgery (VATS).