It can take a long time for fibrotic lung conditions to be diagnosed and may involve various tests. You can find descriptions of some of these on this site. It is important to find out what condition you have as this will lead to better treatment options.
Going through the process can be tiring and worrying for you and people around you. Receiving a diagnosis can be difficult and we all react in different ways. You will find friendly support in the group from members who have received similar news
Before making a diagnosis of lung fibrosis, your medical team will ask you questions about your breathing problems, examine you and arrange specific tests.
The tests and the clinical information taken together are reviewed in a multi-disciplinary team meeting to help the medical team understand your pulmonary fibrosis condition and recommend the most appropriate treatment.
Questions about your breathing
- Your symptoms, including coughing and breathlessness
- Jobs you have had, particularly where you may have been exposed to asbestos, dust from wood or stone, metals, birds or animals
- Your hobbies and pets
- Smoking
- Family history of lung disease
- Your general health
Tests to diagnose pulmonary fibrosis
Pulmonary fibrosis diagnosis involves a number of tests:
- Blood tests to assess for autoimmune diseases
- In a lung function test, you will breathe into a tube so that your medical team can see how well your lungs work. The tests will identify your lung capacity and how well your lungs transfer oxygen to and from your blood. This will help to inform your treatment plan.
- 6 minute walking test to assess if your blood oxygen level falls when you walk.
- A chest x-ray can indicate whether you have scarring in your lungs. Pulmonary fibrosis often starts in the lower part of your lungs whereas sarcoidosis usually involves the mid and upper zones of the lungs.
- A high-resolution CT scan will give a more detailed picture of the inside of your lungs. Typical features of pulmonary fibrosis include fine lines (called reticulations), ‘ground glass’ opacities and honeycombing patterns.
- An echocardiogram looks at how well your heart is working. Increased pressure on the right side of the heart is a sign of pulmonary hypertension – which is a complication of pulmonary fibrosis.
- A bronchoscopy involves a small camera that looks at the airways inside your lungs and takes samples from the lung tissues (bronchial lavage). The camera is passed either through the nose or mouth into your lungs. You will have a local anaesthetic and will not usually have to spend the night at hospital.
- You may also have a bronchial lavage as part of the bronchoscopy, in which small amounts of salty water are passed into the lungs and sucked back out, sampling cells from the lungs that can be analysed to inform your diagnosis.
- A surgical lung biopsy is sometimes necessary when other tests haven’t provided enough information for a certain diagnosis. This is usually performed by keyhole approach called video-assisted thoracoscopic surgery(VATS). You will have a general anaesthetic and have to spend a few days in hospital.