Tomography patterns of lung disease in systemic sclerosis

Abstract

Currently, lung impairment is the leading factor responsible for the morbidity and mortality associated with systemic sclerosis. Therefore, the recognition of the various tomography patterns becomes decisive in the clinical management of these patients. In high-resolution computed tomography studies, the most common pattern is that of nonspecific interstitial pneumonia. However, there are other forms of lung involvement that must also be recognized. The aim of this study was to review the literature on the main changes resulting from pulmonary involvement in systemic sclerosis and the corresponding radiological findings, considering the current classification of interstitial diseases. We searched the Medline (PubMed), Lilacs, and SciELO databases in order to select articles related to pulmonary changes in systemic sclerosis and published in English between 2000 and 2015. The pulmonary changes seen on computed tomography in systemic sclerosis are varied and are divided into three main categories: interstitial, alveolar, and vascular. Interstitial changes constitute the most common type of pulmonary involvement in systemic sclerosis. However, alveolar and vascular manifestations must also be recognized and considered in the presence of atypical clinical presentations and inadequate treatment responses.

High-Resolution Computed Tomography: Lights and Shadows in Improving Care for SSc-ILD Patients

“…The gastrointestinal tract is involved in up to 90% of SSc patients. Moreover, oesophageal involvement is an early sign of the disease diagnosed by a dilated esophagus on CT, with a lumen ranging from 1.2 to 4 cm, containing gas or fluid [70,71].…”

Interstitial lung disease in systemic sclerosis: challenges in early diagnosis and management

“…In the NSIP type, the dominant changes include basal ground-glass opacities, while in UIP, most commonly reticular changes and honeycombing with mainly peripheral and basilar distribution are observed [ 7 , 9 ]. Furthermore, appearance of UIP on HRCT is associated with a poorer prognosis [ 10 , 11 ].…”

“…Also worth a mention is mediastinal lymphadenopathy, which occurs quite often in SSc-ILD patients (41–74%) [ 10 , 17 ]. Although enlarged mediastinal lymph nodes in the course of SSc-ILD are mostly a reactive process (resulting from lung inflammation or reflux), they may also indicate the coexistence of other diseases such as sarcoidosis, tuberculosis or lymphoma [ 10 , 18 ]. Distinguishing between pathologic and nonpathologic lymph nodes is crucial in everyday clinical practice.…”

Avaliação Do Equilíbrio E Do Condicionamento Cardiorrespiratório De Participantes Do Grupo De Atividades Hidrocinesioterapêuticas Do Centro Universitário Franciscano Em Santa Maria, Rs

“…É importante ressaltar que a água permite a imersão e a flutuação corporal, facilitando a reprodução de movimentos compostos de maneira segura e variada, minimizando os impactos (quando comparados com os exercícios no solo), o que pode permitir o trabalho de mobilidade corporal e de flexibilidade de forma segura e gradual (BASTOS;OLIVEIRA, 2003). A FA é uma técnica essencial na movimentação corporal e as propriedades físicas da água provocam efeitos como o relaxamento, a analgesia, a redução do impacto e agressões sobre as articulações, ao contrário dos exercícios no solo, que contribuem para o risco de intercorrências (BIASOLI;MACHADO, 2006).…”