What are the key clinical features that suggest a diagnosis of interstitial lung disease in a primary care setting?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed

Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Key clinical features suggesting interstitial lung disease (ILD) 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 findings that are normal or show a restrictive pattern, though sometimes an obstructive pattern may be present

These features should prompt consideration of ILD and may warrant chest X-ray and referral to a specialist for further assessment and diagnosis .

Key References