Pulmonary fibrosis is a really difficult disease to diagnose. To ensure you get an accurate diagnosis and to determine the type of PF you have, doctors from a variety of specialties, including pulmonologists (respirologists), radiologists, rheumatologists, and pathologists have to work together. To learn more about the types of diagnostics and tests you may have to undergo, we’ve put together this list of 13 pulmonary fibrosis diagnostics and tests (source: Pulmonary Fibrosis Foundation website):
1. Comprehensive Medical History: It is essential for your medical provider to obtain a comprehensive medical history to learn if any medications, environmental/occupational exposures, familial, or other medical conditions could have contributed to your pulmonary fibrosis.
2. Physical Examination: It is important to undergo an in-depth physical examination. Scar tissue can often be heard as “crackles” or Velcro-like sounds when your medical provider listens to your lungs with a stethoscope. Your doctor may also detect signs of other medical conditions which could be affecting your lungs.
3. High-Resolution Computed Tomography (HRCT) scan of the chest: A type of x-ray test that allows your doctor to get a detailed look at your lungs and a critical component of the diagnostic evaluation of PF.
4. Blood Tests: Your medical provider may also perform a series of blood tests to see if your immune system is contributing to your lung disease.
5. Pulmonary Function Tests: Pulmonary Function Tests (PFTs) measure the size of your lungs, how well air moves in and out of your lungs, and how well your lungs bring oxygen into your body. These tests help your medical provider determine the type and severity of lung disease present. They are also used to monitor responses to therapy and disease progression. PFTs are usually performed in a hospital or clinical laboratory and consist of breathing through a ‘spirometer’.
6. Pulse Oximetry: A ‘pulse oximeter’ is a device placed on the fingertip or earlobe that indicates the amount of oxygen in the blood. Normally, nearly all of your red blood cells are full of oxygen. When all the red blood cells are carrying oxygen, the blood is called ‘100% saturated’. A normal saturation level is between 95% – 100% when the test is performed at sea level. Low oxygen saturation values can help your medical professional identify the presence of lung disease.
7. Arterial Blood Gas: Arterial Blood Gas (ABG) is a direct arterial puncture to measure arterial pH, oxygen saturation (PaO2), and carbon dioxide content (PCO2). Arterial blood has been oxygenated by the lungs and thus indicates how much oxygen is available to the body.
8. Bronchoscopy: Bronchoscopy is a procedure used to collect samples of cells and small biopsies from your lungs using a bronchoscope. Examination of these samples can be useful in making a diagnosis of certain types of lung diseases.
9. Bronchoalveolar Lavage: Bronchoalveolar Lavage (BAL) is a way to remove a tiny sampling of cells from the lower respiratory tract using a bronchoscope. During this test, a small amount of saline is injected through the bronchoscope and when withdrawn it removes a sample of cells from the respiratory tract. Usually, this test is not particularly helpful in the diagnosis of PF, but may be beneficial in other clinical situations.
10. Exercise Testing: Exercise testing is a measure of how well the lungs function during exertion. Test methods vary from hospital to hospital but frequently include the use of a stationary bike or treadmill. The most common method of exercise testing is the six-minute walk test, where the distance you can walk in six minutes is measured. Blood pressure, electrocardiogram, and oxygen saturation levels may also be monitored during exercise testing.
11. Esophagram: An X-ray examination of the esophagus (the tube that carries food to your stomach). This exam will help to determine if you suffer from gastroesophageal reflux disease (GERD) or other disorders of the esophagus, which can accompany certain forms of PF.
12. Echocardiogram: An ECHO is a test which uses sound waves (ultrasound) to create a picture of your heart. It provides information about your heart function and screens for the presence of pulmonary hypertension, a condition that can accompany PF.
13. Surgical Lung Biopsy: In some cases a biopsy of the lung is required to make a diagnosis of PF. A biopsy should only be considered after an extensive evaluation. Usually, a lung biopsy can be performed by a minimally invasive procedure called a video-assisted thoracoscopic surgery, or VATS. A VATS procedure is usually well tolerated, but it may not be recommended for all patients. If your medical provider recommends a lung biopsy, he/she will discuss the recommended procedure with you and refer you to a thoracic surgeon.
Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.