The role of shear wave elastography in predicting the development of progressive pulmonary fibrosis in patients with rheumatoid arthritis

BackgroundIn rheumatoid arthritis (RA) patients, lung involvement is a significant issue that decreases exercise capacity beyond joint problems. Our study aimed to compare intercostal and diaphragmatic shear wave elastography (SWE) measurements in RA patients who developed progressive pulmonary fibrosis (PPF) and those who did not. MethodA total of 117 RA patients followed in our hospital between February 2022 and August 2024 were included in the study. Thirty-seven patients with PPF (group 1) and 80 patients without PPF (group 2) were randomized into groups of 30 for analysis. In addition, 20 healthy individuals served as a control group. ResultsA statistically significant difference was observed in both intercostal and diaphragmatic SWE levels between the groups (p < 0.001). RA patients in groups 1 and 2 showed higher intercostal and diaphragmatic SWE levels compared to controls. Diaphragmatic SWE levels were significantly higher in group 1 compared to group 2 (p = 0.01). The cutoff value for diaphragmatic SWE was determined to be 44.7 kPa, with a sensitivity of 78% and specificity of 60%. Additionally, diaphragmatic SWE levels were negatively correlated with fingertip saturation after the 6-min walk test (R = - 0.78, p = 0.01). ConclusionObtaining objective, easily applicable, and low-radiation data is crucial in the early diagnosis and follow-up of PPF. SWE provides a non-invasive method that can be used effectively for the diagnosis and monitoring of PPF in RA patients, contributing to better management of lung involvement in these patients.