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SSc-ILD Imaging — SCE Rheumatology MCQ

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ModerateMusculoskeletal ImagingSSc-ILD ImagingSCE Rheumatology

A 55-year-old woman with diffuse cutaneous systemic sclerosis develops progressive exertional dyspnoea and a dry cough. Pulmonary function tests show a restrictive defect with reduced gas transfer, and HRCT confirms systemic sclerosis-associated interstitial lung disease. Which HRCT pattern is most commonly encountered in this condition?

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Correct answer: E — Non-specific interstitial pneumonia (NSIP)

Non-specific interstitial pneumonia is the most common HRCT pattern in systemic sclerosis-associated ILD. Typical appearances include bilateral basal-predominant ground-glass opacity and fine reticulation, often with traction bronchiectasis and relative subpleural sparing; extensive honeycombing is less characteristic. UIP can occur in SSc but is less frequent and is more strongly associated with rheumatoid arthritis-associated ILD and idiopathic pulmonary fibrosis. Organising pneumonia is uncommon as the dominant SSc pattern. LIP is classically associated with Sjögren disease, while DIP is strongly linked to cigarette smoking and is not a typical SSc-ILD pattern.

Reference: Chatterjee S et al. Viewpoint: a multidisciplinary approach to the assessment of patients with systemic sclerosis-associated interstitial lung disease. Clinical Rheumatology. 2023;42:653–661. https://pubmed.ncbi.nlm.nih.gov/36271064/