eprintid: 10205576 rev_number: 7 eprint_status: archive userid: 699 dir: disk0/10/20/55/76 datestamp: 2025-03-04 12:29:18 lastmod: 2025-03-04 12:29:18 status_changed: 2025-03-04 12:29:18 type: article metadata_visibility: show sword_depositor: 699 creators_name: Vermant, Marie creators_name: Kalkanis, Alexandros creators_name: Jacob, Joseph creators_name: Goos, Tinne creators_name: Cortesi, Emanuela Elsa creators_name: Cypers, Heleen creators_name: De Crem, Nico creators_name: Follet, Tine creators_name: Gogaert, Stefan creators_name: Neerinckx, Barbara creators_name: Taelman, Veerle creators_name: Veyt, Nathalie creators_name: De Sadeleer, Laurens J creators_name: Verschueren, Patrick creators_name: Wuyts, Wim title: Lung ultrasound outperforms symptom-based screening to detect interstitial lung disease associated with rheumatoid arthritis ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: K71 note: This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. abstract: OBJECTIVES: Interstitial lung disease associated with rheumatoid arthritis (RA-ILD) is linked to high mortality. Currently, effective screening tools are lacking. We assessed the role of symptoms and lung ultrasound (LUS) as potential screening tools. METHODS: 116 adult patients with RA presenting to the rheumatology outpatient clinic underwent high-resolution CT (HRCT) scans, pulmonary function tests, LUS (72 zones) and completed a Visual Analogue Scale (VAS) for cough and modified Medical Research Council dyspnoea scale (mMRC). Kruskal-Wallis (KW) tests evaluated the correlation between clinical–radiological HRCT score (no ILD, non-specific abnormalities, subclinical ILD or ILD) and the B-lines on LUS, diffusion capacity (DLCO%pred), forced vital capacity (FVC%pred), VAS Cough and mMRC. Sensitivity and specificity analyses were performed to assess symptom-based questionnaires and the number of B-lines to detect RA-ILD. Area under the receiver operating characteristics (AUROC) for detecting clinical ILD and subclinical ILD were calculated. RESULTS: In 11.8% of patients, an ILD was detected on HRCT. Additionally, in 5%, a diagnosis of subclinical interstitial lung changes was made. The number of B-lines was most strongly associated with the clinical–radiological score (KW χ²=41.2, p=<0.001). DLCO%pred was also significantly correlated with the clinical–radiological score (KW χ²=27.4, p=<0.001), but FVC%pred, mMRC and VAS cough were not. Cough and dyspnoea only weakly predicted the ILD score in the sensitivity–specificity analyses, while B-lines showed AUROCs>0.9 for predicting subclinical and clinical ILD. CONCLUSION: LUS is a promising tool for early detection of RA-ILD, outperforming symptom-based questionnaires or the presence of dyspnoea or cough. date: 2025-01 date_type: published publisher: BMJ official_url: https://doi.org/10.1136/rmdopen-2024-005283 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 2365880 doi: 10.1136/rmdopen-2024-005283 lyricists_name: Jacob, Joseph lyricists_id: JJACO76 actors_name: Jacob, Joseph actors_id: JJACO76 actors_role: owner full_text_status: public publication: RMD Open volume: 11 number: 1 article_number: e005283 issn: 2056-5933 citation: Vermant, Marie; Kalkanis, Alexandros; Jacob, Joseph; Goos, Tinne; Cortesi, Emanuela Elsa; Cypers, Heleen; De Crem, Nico; ... Wuyts, Wim; + view all <#> Vermant, Marie; Kalkanis, Alexandros; Jacob, Joseph; Goos, Tinne; Cortesi, Emanuela Elsa; Cypers, Heleen; De Crem, Nico; Follet, Tine; Gogaert, Stefan; Neerinckx, Barbara; Taelman, Veerle; Veyt, Nathalie; De Sadeleer, Laurens J; Verschueren, Patrick; Wuyts, Wim; - view fewer <#> (2025) Lung ultrasound outperforms symptom-based screening to detect interstitial lung disease associated with rheumatoid arthritis. RMD Open , 11 (1) , Article e005283. 10.1136/rmdopen-2024-005283 <https://doi.org/10.1136/rmdopen-2024-005283>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10205576/1/e005283.full.pdf