Idiopathic pulmonary fibrosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

Patients with idiopathic pulmonary fibrosis usually appear fatigued and short of breath. Physical examination of patients with occupational lung disease is usually remarkable for bronchial breathing, increased vocal resonance, and fine crepitations.

Physical Examination

Appearance of the Patient

Patients with idiopathic pulmonary fibrosis usually appear fatigued and short of breath.[1][2][3]

Vital Signs

Skin

  • Tar staining on fingers from cigarettes
  • Joint swelling and tenderness
    • Features of rheumatological disease
  • Scarring on chest wall may be noted from previous operations
    • May be in mid-axillary line and indicates a chest tube placement, or horizontal postero-lateral scars from lobectomy

HEENT

  • Conjunctival pallor
  • Inflamed nares

Neck

Lungs

Heart

Extremities

References

  1. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK, Colby TV, Cordier JF, Flaherty KR, Lasky JA, Lynch DA, Ryu JH, Swigris JJ, Wells AU, Ancochea J, Bouros D, Carvalho C, Costabel U, Ebina M, Hansell DM, Johkoh T, Kim DS, King TE, Kondoh Y, Myers J, Müller NL, Nicholson AG, Richeldi L, Selman M, Dudden RF, Griss BS, Protzko SL, Schünemann HJ (2011). "An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management". Am. J. Respir. Crit. Care Med. 183 (6): 788–824. doi:10.1164/rccm.2009-040GL. PMC 5450933. PMID 21471066.
  2. Bradley B, Branley HM, Egan JJ, Greaves MS, Hansell DM, Harrison NK, Hirani N, Hubbard R, Lake F, Millar AB, Wallace WA, Wells AU, Whyte MK, Wilsher ML (2008). "Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society". Thorax. 63 Suppl 5: v1–58. doi:10.1136/thx.2008.101691. PMID 18757459.
  3. Steele MP, Speer MC, Loyd JE, Brown KK, Herron A, Slifer SH, Burch LH, Wahidi MM, Phillips JA, Sporn TA, McAdams HP, Schwarz MI, Schwartz DA (2005). "Clinical and pathologic features of familial interstitial pneumonia". Am. J. Respir. Crit. Care Med. 172 (9): 1146–52. doi:10.1164/rccm.200408-1104OC. PMC 2718398. PMID 16109978.

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