Testing & Diagnosis for Interstitial lung disease in Children


At Boston Children’s Hospital, we know that an accurate, timely diagnosis is the first step to effectively treating your child with interstitial lung disease (ILD).

How does Boston Children’s diagnose ILD?

Differential diagnosis

Before establishing a diagnosis of ILD, doctors must rule out other possible causes of the symptoms. This is called making a differential diagnosis. Some of the conditions that cause similar symptoms include:

What about specific tests?

There isn’t a single specific test that can cover the many chILD diseases. Common tests to help diagnose it include:

  • Chest X Ray and high-resolution computed tomography (HRCT): For images of the lungs
  • Pulse oximetry: Measures how well blood is carrying oxygen
  • Pulmonary function tests (PFTs): A series of breathing tests to determine how much, and how well, the lungs take in and expel air
  • Exercise testing: To determine exercise tolerance and oxygen levels during exercise
  • Bronchoscopy with bronchoalveolar lavage: To examine the airways and look for infection and inflammation in the lungs
  • Lung biopsy: The current “gold standard” for diagnosing and categorizing ILD
  • Genetic tests: Very few ILD diseases have known genetic causes. Geneticists test blood and other tissue to detect gene disorders.
  • Barium swallow: Detects signs of aspiration while swallowing food and liquids of different consistencies
  • Ultrasound (echocardiography): Evaluates heart function
  • Sweat testing: To exclude cystic fibrosis
  • Skin testing: To exclude tuberculosis
  • Electrocardiogram EKG and/or cardiac catheterization: Detects heart defects or pulmonary hypertension
  • pH probe: Detects acid reflux
  • Other lab tests of urine, mucus, blood and feces