Subclinical Interstitial Lung Disease in Patients with Systemic Sclerosis. A Pilot Study on the Role of Ultrasound

Reumatol Clin (Engl Ed). 2021 Mar;17(3):144-149. doi: 10.1016/j.reuma.2019.05.004. Epub 2019 Aug 7.
[Article in English, Spanish]

Abstract

Introduction: Interstitial lung disease (ILD) is a common comorbidity present in patients with systemic sclerosis (SSc). Employment of high-resolution computed tomography (HRCT) is very limited and lung ultrasound (LUS) can be an alternative tool for the early evaluation of ILD.

Objective: To determine the validity of LUS in the early detection of ILD in patients with SSc.

Methods: Sixty-eight patients with SSc ≥18 years without respiratory symptoms were included. A rheumatologist rated the subclinical respiratory condition, another rheumatologist blinded to the clinical assessment performed the LUS. To determine validity HRCT was performed as well.

Results: Prevalence of ILD in SSc patients was 41.2% in contrast to the 4.8% healthy controls (P=.0001). Variables associated with LUS and HRCT findings were anti-centromere antibodies (P=.005) and the Rodnan skin score (P=.004). A positive correlation was present between the findings of HRCT and LUS (P=.001). Sensitivity and specificity were 91.2% and 88.6% respectively. Good reliability in the LUS findings was found between observers (k=.72).

Conclusions: By proving to be a valid, trustworthy and feasible alternative tool, we consider that LUS can be implemented for the early detection of ILD in SSc.

Keywords: Enfermedad pulmonar intersticial; Esclerosis sistémica; Interstitial lung disease; Lung ultrasound; Systemic sclerosis; Ultrasonido pulmonar.