How Is Pulmonary Fibrosis Diagnosed?

Your doctor will perform a physical exam and listen to your lungs.

• If your doctor hears a crackling sound when listening to your lungs, that is a sign you might have PF.
• It is also important for your doctor to gather detailed information about your health.
  • This includes any family history of lung disease, any hazardous materials you may have been exposed to in your lifetime and any diseases you’ve been treated for in the past.

There are several ways to test how well your lungs are working.

• Pulmonary Function Tests (PFTs) measure the size of your lungs and how well they move air in and out.
  • This test usually includes blowing into an instrument called a spirometer as hard as you can.
• Pulse oximetry is another tool to see how well your lungs are working.
  • It uses a small device placed on one of your fingers to measure the oxygen level in your blood.
• Doctors may also recommend an exercise stress test that involves exercising on a treadmill or stationary bike while your lung function is monitored.
• An arterial blood gas test involves a simple blood draw, usually taken from an artery in your wrist.
  • The sample is sent to a lab where levels of oxygen and carbon dioxide are measured.

Tests like chest X-rays and CT scans can help your doctor look at your lungs to see if there is any scarring.

• Many people with PF actually have normal chest X-rays in the early stages of the disease.
• A high-resolution computed tomography scan, or HRCT scan, is an X-ray that provides sharper and more detailed pictures than a standard chest X-ray and is an important component of diagnosing PF.
• Your doctor may also perform an echocardiogram (ECHO).
  • This test uses sound waves to look at your heart function.
  • Doctors use this test to detect pulmonary hypertension, a condition that can accompany PF, or abnormal heart function.

Your doctor may want to run additional tests to see if you have any other health conditions.

• One way to do this is through a bronchoscopy, which uses a thin tube inserted down your throat or nose to collect a sample of cells or fluid from your lung.
  • Sometimes a doctor will perform a bronchoalveolar lavage (BAL) during a bronchoscopy.
  • During a BAL, the doctor injects salt water through a bronchoscope into a section of your lung, and then immediately suctions it out.
• If more sampling is required to make a diagnosis, your doctor might perform a biopsy.
  • This can be performed by passing a small biopsy tool during bronchoscopy to collect tissue.
  • This may also require a minimally invasive video assisted thoracoscopic surgery (VAATS) or a more invasive thoracotomy.

Your doctor may want to run additional tests to see if you have any other health conditions.

• An esophagram (an X-ray of the esophagus) is done to see if you have a disorder that affects the esophagus, like gastroesophageal reflux disease (GERD), which can accompany certain forms of PF.
• You might also be given a skin or a blood test for tuberculosis (TB), which can have some of the same symptoms as PF.
• Doctors may also order blood tests to test your liver and kidney function, and to test for other conditions, including joint disorders.