Interstitial Lung Disease

*** In Progress ***

Brandon Fainstad, MD


OBJECTIVES
  1. Describe common radiographic features of various interstitial lung disease
  2. Identify distinguishing characteristics of the most common and reversible etiologies of interstitial lung disease

CASE

65 year-old-man presents to the ED with progressive shortness of breath and dry cough over the past 5 years that has accelerated in recent weeks to the point that he can no longer ambulate.  He denies fevers, chills, chest pain, weight changes, joint pain or skin changes.  Past medical history is notable for atherosclerotic disease with coronary and carotid stents placed 15 years ago, obesity, hypertension and OSA. Only medications are aspirin and a statin.  He has a 90 year tobacco pack year, quit 15 years ago. He is afebrile, HR 110bpm, BP 140/80 with SpO2 74% on room air, improved to 93% after 5 minutes on 100% non-rebreather.

Exam notable for increased work of breathing and diffuse lung crackles.

Portable CXR CT axial CT coronal

What additional history and work-up do you want at this point? 

 

What is your leading diagnosis?


ILD ETIOLOGIES

TERMINOLOGY

Location

Apical vs. basilar

Central vs. Pleural Based vs. 

Extent

Focal vs. diffuse vs. isolated diffuse

Descriptors / Buzz words