Common signs and symptoms include1-3:

dry cough icon

Nonproductive (dry) cough

dyspnea icon

Dyspnea

lung crackle icon

Dry inspiratory crackles,
typically heard at the lung bases

Other signs and symptoms4-6:

  • Finger clubbing
  • Fatigue/weakness
  • Unexplained weight loss
  • Loss of appetite
  • Chest pain
  • Sleeping difficulties

Awareness of patient language can help identify the symptoms of ILD7

In a study investigating patients’ perspectives on living with interstitial lung disease (ILD), common descriptors for "shortness of breath," "breathlessness," and uncomfortable sensations related to inspiration included:

too big of a breath…the bottom of my lungs will cramp can’t get that deep inhale can’t breathe in without it squeezing my chest

Not all breathlessness is COPD, asthma, or CHF8,9

Consider ILD in your patients who experience unexplained breathlessness

Auscultation can provide vital information in an ILD2,3,10

Dry inspiratory crackles at the lung bases can be a key indicator of ILD. Typically, dry inspiratory crackles can be heard during middle to late inspiration, do not clear with cough, and have a short duration.

listen for dry inspiratory crackles at the bases of the lungs graphic listen for dry inspiratory crackles at the bases of the lungs graphic
velcro icon

A particularly distinctive feature of dry inspiratory crackles in ILD is that they sound like *VELCRO® Brand Fastener being peeled apart.2,3

*VELCRO® is a registered trademark. Used with permission.

Listen to the audio clips below and compare dry inspiratory crackles in ILD to other breath sounds.

Dry inspiratory crackles in ILD

Breath sounds of COPD

Normal breath sounds

Note: Recordings were made with a 3MTM Littmann® Electronic Stethoscope 3200 in a clinic setting with patients at rest†

†3M and Littmann are marks and/or registered marks of 3M.

Dry inspiratory crackles are distinct from coarse crackles11-13

Review the chart below to help differentiate the two sounds.

IF YOU HEAR DRY INSPIRATORY CRACKLES AT THE LUNG BASES,
EVALUATE FURTHER FOR ILD AND CONSIDER CONSULTING A
LUNG SPECIALIST

ILD patient 7

…I had never heard of IPF until I was diagnosed. My symptoms began as what I thought was just a bad cold with fits of dry cough.
-Tom, living with IPF

ILD patient 8

I’d taken an afternoon off work to see my doctor about some pretty mild shortness of breath. […] [My doctor] said that my blood oxygen was so low that I could faint if I went to work. -Vicky, living with MCTD-associated ILD

ILD lungs graphic Learn about the range of ILDs
exclamation mark graphic Learn about the role of PCPs
book graphic View resources

IPF, idiopathic pulmonary fibrosis; MCTD, mixed connective tissue disease.

References

  1. Wong C et al. Cureus. 2018;10(10):e3991.
  2. Kraman SS. Arch Intern Med. 1986;146(7):1411-1412.
  3. Raghu G et al; on behalf of the ATS/ERS/JRS/ALAT Committee on Idiopathic Pulmonary Fibrosis. Am J Respir Crit Care Med. 2018;198(5):e44-e68.
  4. Zibrak JD, Price D. NPJ Prim Care Respir Med. 2014;24:14054.
  5. Cosgrove GP et al. BMC Pulm Med. 2018;18(1):9.
  6. Schiza S et al. Eur Respir Rev. 2015;24(136):327-339.
  7. Mittoo S et al. Curr Respir Med Rev. 2015;11(2):175-183.
  8. Mason RJ et al. Murray & Nadel’s Textbook of Respiratory Medicine. 5th ed. Saunders Elsevier; 2010.
  9. Olson AL et al. Patient Relat Outcome Meas. 2016;7:29-35.
  10. Sgalla G et al. BMC Pulm Med. 2018;18(1):103.
  11. Sarkar M et al. Ann Thorac Med. 2015;10(3):158-168.
  12. Mikami R et al. Chest. 1987;92(2):342-345.
  13. Forgacs P. Chest. 1978;73(3):399-405.
  14. Wijsenbeek M et al. N Engl J Med. 2020;383(10):958-968.