• Chiara Cogliati, Marco Antivalle, Daniela Torzillo, Simone Birocchi, Alba Norsa, Roberto Bianco, Giorgio Costantino, Maria Chiara Ditto, Michele Battellino, Pier Carlo Sarzi Puttini, and Nicola Montano.
• 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.
• Rheumatology (Oxford). 2014 Aug 1;53(8):1497-503.

ObjectivesInterstitial 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.MethodsLUS 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.ResultsThirty-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%.ConclusionThe 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.© The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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