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Background <p>Seropositive rheumatoid arthritis (RA) is linked to cardiovascular and pulmonary morbidity. Nevertheless, there is currently no standardized screening method for early detection of RA-associated interstitial lung disease (ILD).</p> Purpose <p>This study proposes using pulmonary function testing (PFT) combined with lung ultrasound (LUS) as additional and radiation-free method to screen for ILD inRF- and ACPA-positive RA patients. Particularly in light of the increased therapeutic options, early detection of RA-ILD is associated with better outcome.</p> Methods <p>We included 214 consecutive patients with diagnosed RF- and ACPA-positive RA in our prospective study. These patients underwent PFT including spirometry, body plethysmography, and cardiopulmonary exercise testing as well as ultrasound examination of the lungs and the heart.</p> Results <p>A total of 203&#xa0;patients (mean age 59 ± 12&#xa0;years, 24% male, 43% current or previous smokers) were examined. The overall average RA duration was 8 ± 7&#xa0;years, with 32% of all patients suffering from an erosive disease course. In PFT, 60&#xa0;patients (30%) showed a limitation in forced vital capacity (FVC) as well as a diffusion disorder, defined as FVC and diffusing capacity of the lung for carbon monoxide (DLCOc) ≤&#xa0;80%. Ultrasound changes were seen in 107&#xa0;patients (53%), with 29% (<i>n</i> = 58) showing typical LUS patterns suspicious of ILD. In summary, ILD was suspected in almost 16% of patients (<i>n</i> = 32). With the combination of PFT and LUS, our ILD screening protocol achieves a high level of sensitivity (93%) and specificity of 72%.</p> Conclusion <p>Our study contributes to the growing body of evidence supporting the use of LUS for screening for RA-associated ILD. We propose that LUS, in conjunction with PFT, serves as a suitable imaging tool for ILD screening in RA.</p>

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Early detection of RA‑ILD—A novel screening protocol with pulmonary function testing and lung ultrasound

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月23日

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  • Carina Fischinger,
  • Florian Popp,
  • Frank Reichenberger,
  • Nikolaus Kneidinger,
  • Robin Tiede,
  • Werner von Wulffen,
  • Martin Welcker

摘要

Background

Seropositive rheumatoid arthritis (RA) is linked to cardiovascular and pulmonary morbidity. Nevertheless, there is currently no standardized screening method for early detection of RA-associated interstitial lung disease (ILD).

Purpose

This study proposes using pulmonary function testing (PFT) combined with lung ultrasound (LUS) as additional and radiation-free method to screen for ILD inRF- and ACPA-positive RA patients. Particularly in light of the increased therapeutic options, early detection of RA-ILD is associated with better outcome.

Methods

We included 214 consecutive patients with diagnosed RF- and ACPA-positive RA in our prospective study. These patients underwent PFT including spirometry, body plethysmography, and cardiopulmonary exercise testing as well as ultrasound examination of the lungs and the heart.

Results

A total of 203 patients (mean age 59 ± 12 years, 24% male, 43% current or previous smokers) were examined. The overall average RA duration was 8 ± 7 years, with 32% of all patients suffering from an erosive disease course. In PFT, 60 patients (30%) showed a limitation in forced vital capacity (FVC) as well as a diffusion disorder, defined as FVC and diffusing capacity of the lung for carbon monoxide (DLCOc) ≤ 80%. Ultrasound changes were seen in 107 patients (53%), with 29% (n = 58) showing typical LUS patterns suspicious of ILD. In summary, ILD was suspected in almost 16% of patients (n = 32). With the combination of PFT and LUS, our ILD screening protocol achieves a high level of sensitivity (93%) and specificity of 72%.

Conclusion

Our study contributes to the growing body of evidence supporting the use of LUS for screening for RA-associated ILD. We propose that LUS, in conjunction with PFT, serves as a suitable imaging tool for ILD screening in RA.