Pleural irregularity and diaphragm mobility among patients with systemic sclerosis

Background: Pleural irregularity visualized by ultrasound has a higher specificity for interstitial lung disease (ILD) than B lines. It is manifested as a loss of the normal hyperechoic pleural contour. Diaphragm mobility has not been studied so far in patients with systemic sclerosis (SSc). Patients may have reduced diaphragm function due to ILD, disuse atrophy, malnutrition, corticosteroid therapy, etc. Aims and objectives: To investigate whether pleural irregularity is associated with diaphragm mobility in patients with SSc. Methods: In this cross sectional multicentric research participated 50 patients with systemic sclerosis. The patients underwent an ultrasound of the pleura. The mobility of the right diaphragm was measured in M mode with convex probe. We applied reference values for diaphragm mobility in deep breathing according to Boussuges et al. (1). Results: In patients with reduced mobility of the diaphragm in deep breathing, regression analysis pointed that irregular pleura on ultrasound was an independent factor predicting reduced diaphragm mobility (OR=40.0, 95% CI: 1.98 to 807.1). Conclusion: According to the results, irregular pleura on ultrasound is independent factor that predicts reduced mobility of the diaphragm in deep breathing among the patients with SSc. Literature: 1. Boussuges A, Gole Y, Blanc P. Diaphragmatic motion studied by m-mode ultrasonography: methods, reproducibility, and normal values. Chest 2009;135:391-400.