Open Access Rheumatology: Research and Reviews (Jan 2024)
Usefulness of Lung Ultrasound as a Method for Early Diagnosis of Interstitial Lung Disease in Patients with Rheumatoid Arthritis
Abstract
Pedro Santos-Moreno,1 Maria Fernanda Linares-Contreras,1 Gabriel-Santiago Rodríguez-Vargas,2 Pedro Rodríguez-Linares,2 Abdón Mata-Hurtado,3 Linda Ibatá,4 Susan Martínez,4 Adriana Rojas-Villarraga,1,5 Mario Diaz,1 Esther F Vicente-Rabaneda,6 Maritza Quintero,7 Ingrid Möller7 1Rheumatology Department, Biomab IPS, Bogotá, Colombia; 2Research department, Biomab IPS, Bogotá, Colombia; 3Fundación Neumológica Colombiana, Bogotá, Colombia; 4Epidemiology department, Biomab IPS, Bogotá, Colombia; 5Research Institute, Fundación Universitaria de Ciencias de La Salud – FUCS, Bogotá, Colombia; 6Rheumatology, Hospital Universitario La Princesa, Madrid, Spain; 7POAL Rheumatology Institute, Rheumatology, Barcelona, SpainCorrespondence: Pedro Santos-Moreno, Rheumatology department, Biomab IPS, 48th Street #13-86, Bogotá, 110221, Colombia, Tel +57 320 8094232, Email [email protected]: To determine the value of lung ultrasound (LUS) compared to high-resolution computed tomography (HRCT) in the early diagnosis of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA).Patients and Methods: An observational prospective study was performed. Were included patients with respiratory symptoms or/and, patients with crackles in auscultation during medical consultation. All patients underwent to chest X-rays, LUS, HRCT,and respiratory function tests.Results: A total of 192 patients with RA were included. Mean disease duration was 16.8 ± 11.1 years. 72% were positive for rheumatoid factor or anti-citrullinated antibodies. Of the total number of subjects, 54.7% had respiratory symptoms. The other patients did not have respiratory symptoms, but they did have had crackles on pulmonary auscultation. B lines > 11.5 on the ROC curve predicted ILD (AUC 0.63; CI 95%: 0.55– 0.71; p < 0.003). A DLCO value of < 7.13 significantly predicted the presence of ILD (AUC 0.61; 95% CI: 0.52– 0.70; p < 0.028).Conclusion: The findings of this study suggest that LUS is a valuable tool for the early diagnosis of ILD in patients with RA, and together with DLCO, can adequately predict the presence of ILD in this population. LUS also helps to determine which patients with respiratory symptoms and signs suggestive for ILD are undergo to HRCT.Keywords: rheumatoid arthritis, interstitial lung diseases, respiratory function tests