The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis
Abstract Background To investigate the diagnostic accuracy of lung ultrasound (LUS) for interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). Methods This retrospective study included patients over 18 years with RA evaluated at the Department of Rheumatology and Immunology of S...
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BMC
2025-07-01
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| Series: | Arthritis Research & Therapy |
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| Online Access: | https://doi.org/10.1186/s13075-025-03626-4 |
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| author | Shaoyu Zheng Zexuan Zhou Guangzhou Du Qingzi Chen Shaoqi Chen Jianqun Lin Shijian Hu Weijin Zhang Kedi Zheng Jinghua Zhuang Meigan Huang Barbara Ruaro Cosimo Bruni Anna-Maria Hoffmann-Vold Marco Matucci-Cerinic Daniel E. Furst Yukai Wang |
| author_facet | Shaoyu Zheng Zexuan Zhou Guangzhou Du Qingzi Chen Shaoqi Chen Jianqun Lin Shijian Hu Weijin Zhang Kedi Zheng Jinghua Zhuang Meigan Huang Barbara Ruaro Cosimo Bruni Anna-Maria Hoffmann-Vold Marco Matucci-Cerinic Daniel E. Furst Yukai Wang |
| author_sort | Shaoyu Zheng |
| collection | DOAJ |
| description | Abstract Background To investigate the diagnostic accuracy of lung ultrasound (LUS) for interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). Methods This retrospective study included patients over 18 years with RA evaluated at the Department of Rheumatology and Immunology of Shantou Central Hospital. All patients underwent chest high-resolution computed tomography (HRCT) and LUS within one month. The LUS was performed in a total of 50 scanning sites (ScS), and the number of B-lines present in each ScS was counted and summed up as B-lines score. A positive judgement was given on LUS when the B-lines score exceeded 10. The presence and patterns of ILD were defined by HRCT findings. ROC curve analysis was used to calculate the accuracy of LUS to detect ILD. Results A total of 120 RA patients (86 women, with a median age of 56.0 [50.0–64.0] years) were enrolled. Based on the HRCT, 76 patients were found to have radiographic ILD, with 63 exhibiting nonspecific interstitial pneumonia (NSIP) and 13 showing usual interstitial pneumonia (UIP). Sonographic ILD was detected in 76 patients who underwent LUS examination. The concordance rate between two modalities was 83.33% (Kappa value = 0.64, 95% CI 0.50–0.78). The diagnostic sensitivity and specificity of LUS were 86.84% and 77.27%, respectively. The positive predictive value, negative predictive value, a positive likelihood ratio and a negative likelihood ratio were 86.84%, 77.27%, 3.82, and 0.17, respectively. The number of B-lines in RA with ILD and without ILD on HRCT showed a significant difference (34.0 [15.0–96.5] vs. 6.5 [2.5–10.0], P < 0.001). The presence of 12 B-lines on 50 ScS was the optimal cutoff value for detecting RA-ILD (AUC = 0.89, 95% CI 0.82–0.94, sensitivity of 85.53%, specificity of 81.82%, P < 0.001). Conclusions Lung ultrasound is a valuable diagnostic tool for RA-ILD and can be used as a screening method to identify patients who require further evaluation with chest HRCT. |
| format | Article |
| id | doaj-art-c50477a0f98d4160a18b1cbdb5ce69e5 |
| institution | Kabale University |
| issn | 1478-6362 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Arthritis Research & Therapy |
| spelling | doaj-art-c50477a0f98d4160a18b1cbdb5ce69e52025-08-20T03:43:01ZengBMCArthritis Research & Therapy1478-63622025-07-0127111010.1186/s13075-025-03626-4The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritisShaoyu Zheng0Zexuan Zhou1Guangzhou Du2Qingzi Chen3Shaoqi Chen4Jianqun Lin5Shijian Hu6Weijin Zhang7Kedi Zheng8Jinghua Zhuang9Meigan Huang10Barbara Ruaro11Cosimo Bruni12Anna-Maria Hoffmann-Vold13Marco Matucci-Cerinic14Daniel E. Furst15Yukai Wang16Department of Rheumatology and Immunology, Shantou Central HospitalDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Radiology, Shantou Central HospitalDepartment of Ultrasound, The First Affiliated Hospital of Shantou University Medical CollegeDepartment of Ultrasound, The First Affiliated Hospital of Shantou University Medical CollegeDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Rheumatology and Immunology, Shantou Central HospitalDepartment of Clinical Laboratory, Shantou Central HospitalDepartment of Pulmonology, Cattinara Hospital, University of TriesteDepartment of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of FlorenceDepartment of Rheumatology, Oslo University HospitalDepartment of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of FlorenceDepartment of Experimental and Clinical Medicine, Division of Rheumatology, Careggi University Hospital, University of FlorenceDepartment of Rheumatology and Immunology, Shantou Central HospitalAbstract Background To investigate the diagnostic accuracy of lung ultrasound (LUS) for interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA). Methods This retrospective study included patients over 18 years with RA evaluated at the Department of Rheumatology and Immunology of Shantou Central Hospital. All patients underwent chest high-resolution computed tomography (HRCT) and LUS within one month. The LUS was performed in a total of 50 scanning sites (ScS), and the number of B-lines present in each ScS was counted and summed up as B-lines score. A positive judgement was given on LUS when the B-lines score exceeded 10. The presence and patterns of ILD were defined by HRCT findings. ROC curve analysis was used to calculate the accuracy of LUS to detect ILD. Results A total of 120 RA patients (86 women, with a median age of 56.0 [50.0–64.0] years) were enrolled. Based on the HRCT, 76 patients were found to have radiographic ILD, with 63 exhibiting nonspecific interstitial pneumonia (NSIP) and 13 showing usual interstitial pneumonia (UIP). Sonographic ILD was detected in 76 patients who underwent LUS examination. The concordance rate between two modalities was 83.33% (Kappa value = 0.64, 95% CI 0.50–0.78). The diagnostic sensitivity and specificity of LUS were 86.84% and 77.27%, respectively. The positive predictive value, negative predictive value, a positive likelihood ratio and a negative likelihood ratio were 86.84%, 77.27%, 3.82, and 0.17, respectively. The number of B-lines in RA with ILD and without ILD on HRCT showed a significant difference (34.0 [15.0–96.5] vs. 6.5 [2.5–10.0], P < 0.001). The presence of 12 B-lines on 50 ScS was the optimal cutoff value for detecting RA-ILD (AUC = 0.89, 95% CI 0.82–0.94, sensitivity of 85.53%, specificity of 81.82%, P < 0.001). Conclusions Lung ultrasound is a valuable diagnostic tool for RA-ILD and can be used as a screening method to identify patients who require further evaluation with chest HRCT.https://doi.org/10.1186/s13075-025-03626-4Rheumatoid arthritisInterstitial lung diseaseHigh-resolution computed tomographyLung ultrasoundB-lines |
| spellingShingle | Shaoyu Zheng Zexuan Zhou Guangzhou Du Qingzi Chen Shaoqi Chen Jianqun Lin Shijian Hu Weijin Zhang Kedi Zheng Jinghua Zhuang Meigan Huang Barbara Ruaro Cosimo Bruni Anna-Maria Hoffmann-Vold Marco Matucci-Cerinic Daniel E. Furst Yukai Wang The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis Arthritis Research & Therapy Rheumatoid arthritis Interstitial lung disease High-resolution computed tomography Lung ultrasound B-lines |
| title | The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| title_full | The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| title_fullStr | The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| title_full_unstemmed | The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| title_short | The diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| title_sort | diagnostic utility of lung ultrasound in the assessment of interstitial lung disease associated with rheumatoid arthritis |
| topic | Rheumatoid arthritis Interstitial lung disease High-resolution computed tomography Lung ultrasound B-lines |
| url | https://doi.org/10.1186/s13075-025-03626-4 |
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