Clinical manifestations and consequences
Typically, patients with ILD complain of breathlessness and decreased exercise tolerance. Clinical examination shows inspiratory ‘crackles’ audible on auscultation of the lungs. At a later stage, cyanosis and clubbing of the fingers and toes may be evident. Lung function tests show decreased lung volumes and low carbon monoxide diffusing capacity with hypoxaemia, especially on exercise. Chest radiography shows small lungs and increased interstitial markings. CT of the thorax is very important in both diagnosis and assessment, as is lung histology, if available, for revealing the characteristic patterns of ILD.