What are the key diagnostic criteria for idiopathic pulmonary fibrosis in primary care?

Key diagnostic criteria for idiopathic pulmonary fibrosis (IPF) in primary care include:

• Age over 45 years.
• Persistent breathlessness on exertion.
• Persistent cough.
• Bilateral inspiratory crackles on chest auscultation.
• Clubbing of the fingers.
• Spirometry results that are normal or show an impaired restrictive pattern (sometimes obstructive).

Initial assessment should include a detailed history, clinical examination, and blood tests to exclude alternative diagnoses such as environmental/occupational lung diseases, connective tissue diseases, and drug-induced lung disease.

Primary care should also arrange lung function testing (spirometry and gas transfer) and review chest X-ray results.

Referral for high-resolution CT of the thorax and specialist multidisciplinary team assessment is required for definitive diagnosis.

Diagnosis of IPF must be confirmed by a multidisciplinary team based on clinical features, lung function, radiological findings, and pathology if indicated.