ORIGINAL RESEARCH article
Front. Med.
Sec. Rheumatology
Rheumatoid Arthritis associated Interstitial Lung Disease: Diagnostic Accuracy of Lung Ultrasound Compared to Chest High Resolution Computed Tomography
Rim Dhahri 1
Islem Mejri 1
Ichrak OUsleti 1
Soumaya Boussaid 2
Lobna Ben Ammar 1
HIBA BEN AYED 1
Tasnim Znegui 1
Refka Jebri 1
Chirine Moussa 1
Zied Moatamri 1
Khalil Amri 1
Moncef Aloui 1
Imen Gharsallah 1
1. Hopital Militaire Principal d'Instruction de Tunis, Tunis, Tunisia
2. Hôpital La Rabta, Tunis, Tunisia
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Abstract
Abstract: interstitial lung disease (ILD) affects up to 60% of rheumatoid arthritis (RA) patients. Chest high resolution computed tomography (HRCT) remains the gold standard for diagnosis; However, chest HRCT involves radiation exposure. Despite its safety, lung ultrasound (LUS) is not yet validated for the diagnosis of ILD in RA. We conducted a prospective, single-center cross-sectional study including patients followed for RA. The following exclusion criteria were applied: pregnancy, history of heart failure, acute cardiac decompensation, recent respiratory symp-toms within the last three months, and recent pneumonia within the past month. All included pa-tients underwent both LUS and HRCT. Among the 73 patients, there were 18 men and 55 women. The mean age was 55 ± 12 years. The mean Disease Activity Score DAS28-ESR was 3.47 ± 1.40. Chest HRCT identified ILD in 28.8%. According to the semi-quantitative ultrasound score, interstitial involvement was detected in 21.9% of patients. The sensitivity of LUS was 59.1%, and the specificity was 94.12%. ROC curve analysis demonstrated an area under the curve (AUC) of 0.813. the optimal cutoff was 5 B-lines, yielding a sensitivity of 63.6% and a specificity of 94.1%. this study demonstrates the good diagnostic performance of LUS for ILD detection.
Summary
Keywords
High resolutionComputed Tomography, interstitial lung disease 2, lung disease, lung ultrasound 3, Rheumatoid arthritis 1
Received
24 December 2025
Accepted
02 February 2026
Copyright
© 2026 Dhahri, Mejri, OUsleti, Boussaid, Ben Ammar, BEN AYED, Znegui, Jebri, Moussa, Moatamri, Amri, Aloui and Gharsallah. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Soumaya Boussaid
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