Steps to diagnose ILD in practice - Dr. Sheetu Singh

1. Getting to the base camp: how to approach a patient with ILD Dr Sheetu Singh Director, RHL Lung Center, Jaipur

2. ILD

3. Steps to diagnose ILD in practice Step 1: Suspect in OPD →Clinically Step 2: Confirm ILD →HRCT Step 3: Classify ILD →Re-review of history & other investigations

4. Symptoms • Dyspnoea on exertion • Cough – usually dry • Loss of weight and appetite • Fatigue • Wheezing, hemoptysis, and chest pain (rare symptoms) Non specific

5. ILD India registry AJRCCM 2017 How an ILD patient comes to us? (12%) (12%) Dyspnea 91% Cough 82% (18%) (26%) (29%) (82%) (91%)

6. Physical examination • Clubbing • “Velcro rales” or “Basal crepitations” are common in most forms of ILD • Inspiratory squeaks: characteristic of hypersensitivity pneumonitis ILD registry patients Basal crepts 79%