Evolving concepts in the early and accurate diagnosis of idiopathic pulmonary fibrosis.

The diagnosis of idiopathic pulmonary fibrosis (IPF) requires an integrated multidisciplinary approach involving pulmonologists, radiologists, and pathologists. Early recognition of IPF and of its differentiation from other interstitial lung diseases is important for directing patient management and predicting prognosis. Clinical suspicion of IPF should be raised when patients, particularly those over 50 years of age, present with dyspnea that is gradual in onset and progressive. A confident diagnosis of IPF can be made based on clinical assessment, pulmonary function test results, and radiographic and bronchoscopic evaluation. However, the definitive diagnosis of IPF requires a surgical lung biopsy to confirm the histopathologic pattern of usual interstitial pneumonia.