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Tests and diagnosis
By Mayo Clinic staff
To distinguish pneumonitis from other lung disorders, you'll likely have one or more of the following tests.
Imaging tests
In most cases, pneumonia affects only a small, localized portion of your lungs, while the effects of pneumonitis are often spread throughout all five lobes of your lungs.
- Chest X-ray. This painless test causes a small amount of radiation to pass through your chest to produce images of your lungs. X-rays take only a few minutes to perform.
- Computerized tomography (CT) scan. CT scans combine X-ray images taken from many different angles into detailed cross-sectional images. This painless test involves lying on a narrow table that slides into a large, doughnut-shaped machine. CT scans typically take less than 15 minutes to perform. Computerized tomography gives much greater detail of changes in your lungs than what a chest X-ray can provide.
Blood tests
Your doctor may order blood tests that will check the status of your overall health. Blood tests can also be helpful in diagnosing farmer's lung.
Pulmonary function tests
A test called spirometry measures the amount of air that you're able to inhale and exhale in a specific period of time. Your doctor may also measure how efficiently your lungs transfer gases from the air into the bloodstream during exercise.
Another way to assess the efficiency of your lungs is to measure the oxygen saturation in your blood with an oximeter — a device painlessly clamped onto your finger.
Bronchoscopy
A bronchoscopy is a procedure that uses a flexible tube threaded down your throat to view your airways and collect samples from your lungs. Your doctor will spray an anesthetic in the back of your mouth and throat and will give you medication through a vein in your arm to help you relax.
Once the tube is in place, your doctor may flush a section of your lung with a saltwater solution to collect lung cells and other materials. This "flushing" procedure is known as a lavage. Your doctor may also insert a tiny tool through the bronchoscope to biopsy a sample of cells from the lung tissue.
Surgical lung biopsy
In some cases, your doctor may want to examine a larger sample of tissue from several locations within your lungs that cannot be reached via bronchoscopy. A surgical procedure to obtain these samples may be necessary.
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- Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. April 21, 2009.
- Hanak V, et al. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis. Mayo Clinic Proceedings. 2007;7:812.
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- Idiopathic pulmonary fibrosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ipf/ipf_all.html. Accessed April 16, 2009.
- Pulmonary complications. Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/132163627-4/830632837/1565/144.html#4-u1.0-B978-1-4160-3675-3..50019-8--cesec43_644. Accessed April 17, 2009.
- King TE. Diagnosis of hypersensitivity pneumonitis (extrinsic allergic alveolitis). http://www.uptodate.com/home/index.html. Accessed April 17, 2009.
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