title: Standard and pocket-size lung ultrasound devices can detect interstitial lung disease in rheumatoid arthritis patients.
abstract: OBJECTIVE
  Interstitial lung disease (ILD) is a frequent extra-articular manifestation of RA associated with increased mortality. High-resolution CT (HRCT) is used for diagnosis and follow-up, but its accuracy is counterbalanced by high costs and radiological risk. In the presence of ILD, lung US (LUS) detects vertical artefacts called B-lines. The aims of the present study were to evaluate the accuracy of LUS in the diagnosis of ILD in RA and to validate the use of a pocket-size US device (PS-USD) as a screening tool.
  
  
  METHODS
  LUS was performed with standard equipment by a trained physician through longitudinal scans following anatomical lines: 72 segments were considered (28 anteriorly and 44 posteriorly) and B-lines were counted in each segment. A B-lines score >10 identified a positive examination (presence of ILD). A second LUS session for positive/negative judgment was performed by a short-trained physician using a PS-USD.
  
  
  RESULTS
  Thirty-nine patients were studied. The sensitivity and specificity of standard LUS vs HRCT were 92% and 56%, respectively. The B-line score was significantly correlated with HRCT score (r = 0.806). A total of 29 patients were studied with a PS-USD. Sensitivity and specificity for PS-USD vs HRCT were 89% and 50%.
  
  
  CONCLUSIONS
  The sensitivity of LUS in the detection of ILD supports its use as a screening test for ILD in RA patients, even in the ambulatory setting with a PS-USD. The strong correlation between echographic and HRCT scores indicates LUS is a valid tool for grading and follow-up of ILD.
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy. chiaracogliati@fastwebnet.it.
authors.forename: Chiara
authors.initials: C
authors.lastname: Cogliati
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Antivalle
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Torzillo
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Birocchi
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Norsa
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianco
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Costantino
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Ditto
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Battellino
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Pier Carlo
authors.initials: PC
authors.lastname: Sarzi Puttini
authors.affiliation: Department of Internal Medicine, Division of Rheumatology and Division of Radiology, L. Sacco Hospital, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Montano
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014463:Ultrasonography
keywords: B-lines; interstitial lung disease; lung ultrasound; pocket-size ultrasound device; rheumatoid arthritis