Education＆ScienceEducational Article

Comment by Mark Lavercombe: With every passing year the utility of lung ultrasound (LUS) becomes more evident, and in this paper, the authors demonstrate using LUS using a 14-intercostal space scanning method as a screening tool for interstitial lung disease (ILD) in patients with connective tissue disease (CTD). In 206 patients with CTD, 145 were classified as having ILD, 31 as non-ILD and 30 patients who were classified as ‘pre-clinical ILD’. Quantitative computed tomography (QCT) scoring was compared with LUS scoring and clinical parameters and cut points for diagnosing ILD vs pre-clinical and non-ILD determined. Their chosen cut-off demonstrated 93.8% sensitivity and negative predictive value of 85.5%, with an area under the receiver operating curve (AUROC) of 0.9648 (95% CI 0.942-0.988, p<0.0001). Conversely, a different cut point to identify non-ILD from pre-clinical ILD and ILD demonstrated an AUROC of 0.9654 (95% CI: 0.943–0.988; p<0.0001). Correlation was demonstrated between LUS and QCT for disease extent.