The lung is frequently involved in patients with systemic sclerosis (SSc). Risk factors for the development of interstitial lung disease (ILD) include diffuse skin involvement (proximal to the metacarpal phalangeal joints), and the presence of anti-Scl-70 anti-topoisomerase antibodies. The risk of developing ILD is greatest early in the course of SSc. Even in patients with fibrosis on chest CT, pulmonary function tests can be normal. Diffusing capacity for carbon monoxide (DLCO) may be reduced as a result of pulmonary hypertension and not ILD. Therefore, many experts recommend a chest CT in patients with SSc especially with diffuse disease and with anti-Scl antibodies.¹ A review of SSc patients with anti-Scl antibodies showed that 74.0% to 82.9% had a chest CT between 2018 and 2022. A chart review of 16 patients who did not obtain a chest CT showed that 75% of these patients had a chest CT performed outside Cleveland Clinic.
¹Cottin V, Brown KK. Respiratory Research 2019;20:13.