Clubbing of the fingers in<unk>  In many people, symptoms are present for a considerable time before diagnosis. The most common clinical features of<unk>  include the following: * Age over 50 years * Dry, non-productive cough on exertion * Progressive exertional dyspnea (shortness of breath with exercise) * Dry, inspiratory bibasilar "velcro-like" crackles on auscultation (a crackling sound in the lungs during inhalation similar to Velcro being torn apart slowly, heard with a stethoscope). * Clubbing of the digits, a disfigurement of the finger tips or toes (see image) * Abnormal pulmonary function test results, with evidence of restriction and impaired gas exchange. Some of these features are due to chronic hypoxemia (oxygen deficiency in the blood), are not specific for<unk> , and can occur in other pulmonary disorders.<unk>  should be considered in all patients with unexplained chronic exertional dyspnea who present with cough, inspiratory bibasilar crackles, or finger clubbing. Assessment of "velcro" crackles on lung auscultation is a practical way to improve the earlier diagnosis of<unk> . Fine crackles are easily recognized by clinicians and are characteristic of<unk> . If bilateral fine crackles are present throughout the inspiratory time and are persisting after several deep breaths, and if remaining present on several occasions several weeks apart in a subject aged ≥60 years, this should raise the suspicion of<unk>  and lead to consideration of an HRCT scan of the chest which is more sensitive than a chest X-ray. As crackles are not specific for<unk> , they must prompt a thorough diagnostic process.
Idiopathic pulmonary fibrosis
Sarcoidosis
Mineral dust airway disease
Hypersensitivity pneumonitis
Allergic bronchopulmonary aspergillosis
Interstitial lung disease
Rheumatoid lung disease
Idiopathic interstitial pneumonia