Tutorial presented by Dr Mia Gillett, Respiratory registrar.

Part of the examination of a patient presenting with breathlessness should include a chest auscultation, and crackles on chest auscultation is an important feature of ILD.

The nature of the crackles in ILD is typically ‘fine’, like the sound of velcro, and tend to be heard at the end inspiratory phase, typically at the lung bases.

Check out this audio clip, sourced from this website. 

The presence of fine crackles on auscultation should increase the suspicion of ILD.

It is also important to remember that the absence of crackles does not exclude a diagnosis of ILD.