https://doi.org/10.4081/reumatismo.2024.1651
Clinical utility of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis
Submitted: 13 September 2023
Accepted: 23 May 2024
Published: 3 October 2024
Accepted: 23 May 2024
Abstract Views: 673
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Objective. To establish the diagnostic value of lung ultrasound (LUS) in patients with rheumatoid arthritis (RA) for the detection of interstitial lung disease (ILD).
Methods. A cross-sectional study was performed. Consecutive patients with RA (American College of Rheumatology/European League Against Rheumatism 2010 criteria) who had a chest high-resolution computed tomography (HRCT) performed within 12 months before inclusion, regardless of symptomatology, were included. Demographic, clinical, laboratory, and pharmacological data were recorded. Each patient underwent a LUS with assessment of B-lines (BL) and pleural irregularities (PI). HRCT was considered the gold standard for the confirmatory diagnosis of ILD. Receiver operating characteristic (ROC) curves were calculated to test the ability of LUS findings (BL and PI) in discriminating patients with ILD.
Results. A total of 104 RA patients were included, of which 21.8% had ILD. Patients with ILD had more BL (median 26 versus 1, p<0.001) and PI (median 16 versus 5, p<0.001) than patients without ILD. The diagnostic accuracy in ROC curves was: area under the curve (AUC) 0.88 and 95% confidence interval (CI) 0.78-0.93 for BL and AUC 0.82 and 95% CI 0.74-0.89 for PI. The best cut-off points for (ILD detection) discriminating the presence of significant interstitial lung abnormalities were 8 BL and 7 PI.
Conclusions. The presence of 8 BL and/or 7 PI in the LUS showed an adequate cut-off value for discriminating the presence of significant interstitial lung abnormalities, evocative of ILD.
Cogliati C, Antivalle M, Torzillo D, Birocchi S, Norsa A, Bianco R, et al. Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients. Rheumatology 2014; 53: 1497-503.
DOI: https://doi.org/10.1093/rheumatology/keu033
Farquhar HJ, Beckert N, Beckert L, Edwards AL, Matteson EL, Frampton C, et al. Survival of adults with rheumatoid arthritis associated interstitial lung disease - a systematic review and meta-analysis. Semin Arthritis Rheum 2023; 60: 152187.
DOI: https://doi.org/10.1016/j.semarthrit.2023.152187
Cavagna L, Monti S, Grosso V, Boffini N, Scorletti E, Crepaldi G, et al. The multifaceted aspects of interstitial lung disease in rheumatoid arthritis. Biomed Res Int 2013.
DOI: https://doi.org/10.1155/2013/759760
Kadura S, Raghu G. Rheumatoid arthritis-interstitial lung disease: manifestations and current concepts in pathogenesis and management. Eur Respir Rev 2021; 30: 210011.
DOI: https://doi.org/10.1183/16000617.0011-2021
Moazedi-Fuerst FC, Kielhauser SM, Scheidl S, Tripolt NJ, Lutfi A, Yazdani-Biuki B, et al. Ultrasound screening for interstitial lung disease in rheumatoid arthritis. Clin Exp Rheumatol 2014; 32: 199-203.
Gutierrez M, Ruta S, Clavijo-Cornejo D, Fuentes-Moreno G, Reyes-Long S, Bertolazzi C. The emerging role of ultrasound in detecting interstitial lung disease in patients with rheumatoid arthritis. Joint Bone Spine 2022; 89: 105407.
DOI: https://doi.org/10.1016/j.jbspin.2022.105407
Gutierrez M, Tardella M, Rodriguez L, Mendoza J, Clavijo-Cornejo D, García A, et al. Ultrasound as a potential tool for the assessment of interstitial lung disease in rheumatic patients. Where are we now? Radiol Med 2019; 124: 989-99.
DOI: https://doi.org/10.1007/s11547-019-01053-5
Gutierrez M, Salaffi F, Carotti M, Tardella M, Pineda C, Bertolazzi C, et al. Utility of a simplified ultrasound assessment to assess interstitial pulmonary fibrosis in connective tissue disorders - preliminary results. Arthritis Res Ther 2011; 13: R134.
DOI: https://doi.org/10.1186/ar3446
Pinal-Fernandez I, Pallisa-Nuñez E, Selva-O'Callaghan A, Castella-Fierro E, Simeon-Aznar CP, Fonollosa-Pla V, et al. Pleural irregularity, a new ultrasound sign for the study of interstitial lung disease in systemic sclerosis and antisynthetase syndrome. Clin Exp Rheumatol 2015; 33: S136-41.
Delle Sedie A, Terslev L, Bruyn GAW, Cazenave T, Chrysidis S, Diaz M, et al. Standardization of interstitial lung disease assessment by ultrasound: results from a Delphi process and web-reliability exercise by the OMERACT ultrasound working group. Semin Arthritis Rheum 2024; 65: 152406.
DOI: https://doi.org/10.1016/j.semarthrit.2024.152406
Mena-Vázquez N, Jimenez-Núñez FG, Godoy-Navarrete FJ, Manrique-Arija S, Aguilar-Hurtado MC, Romero-Barco CM, et al. Utility of pulmonary ultrasound to identify interstitial lung disease in patients with rheumatoid arthritis. Clin Rheumatl 2021; 40: 2377-85.
DOI: https://doi.org/10.1007/s10067-021-05655-1
Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis 2010; 69: 1580-8.
DOI: https://doi.org/10.1136/ard.2010.138461
Hatabu H, Hunninghake GM, Richeldi L, Brown KK, Wells AU, Remy-Jardin M, et al. Interstitial lung abnormalities detected incidentally on CT: a position paper from the Fleischner Society. Lancet Respir Med 2020; 8: 726-37.
DOI: https://doi.org/10.1016/S2213-2600(20)30168-5
Carley S, Dosman S, Jones SR, Harrison M. Simple nomograms to calculate sample size in diagnostic studies. Emerg Med J 2005; 22: 180-1.
DOI: https://doi.org/10.1136/emj.2003.011148
Di Carlo M, Tardella M, Filippucci E, Carotti M, Salaffi F, Carlo M Di, et al. Lung ultrasound in patients with rheumatoid arthritis: definition of significant interstitial lung disease. Clin Exp Rheumatol 2022; 40: 495-500.
DOI: https://doi.org/10.55563/clinexprheumatol/gioptt
Joy GM, Arbiv OA, Wong CK, Lok SD, Adderley NA, Dobosz KM, et al. Prevalence, imaging patterns and risk factors of interstitial lung disease in connective tissue disease: a systematic review and meta-analysis. Eur Respir Rev 2023; 32: 220210.
DOI: https://doi.org/10.1183/16000617.0210-2022
How to Cite
Tanten Zabaleta, R., Marín, J., Zacariaz Hereter, J., Maritano, J., Fullana, M., Alvarado, N., … Rosa, J. (2024). Clinical utility of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis. Reumatismo. https://doi.org/10.4081/reumatismo.2024.1651
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