Objective: Interstitial lung disease (ILD) is a common feature of connective tissue disease (CTD). The diagnosis of CTD-ILD can be challenging and is important for therapeutic decisions. In this study, we aimed to determine whether a systematic rheumatological assessment could help pulmonologists in the diagnosis and care of ILD patients.

Method: We conducted an observational single-centre study of patients with ILD. All patients underwent standardized pulmonary and rheumatological evaluations, including clinical evaluation (pulmonary symptoms and musculoskeletal signs), immunological screening, chest high-resolution computed tomography, pulmonary function tests, and ultrasonography (US) of joints and major salivary glands.

Results: We included 100 consecutive ILD patients (47% women, mean ± sd age 67 ± 14 years); 15 patients already had CTD. The main extrapulmonary symptoms were joint pain (n = 52), joint swelling (n = 26), and sicca syndrome (n = 33). US of joints revealed synovitis, bone erosion, and tenosynovitis in 37, 17, and 13 patients, respectively. US of major salivary glands detected features associated with Sjögren’s syndrome in 13 patients. After rheumatological evaluation, CTD-ILD was confidently diagnosed in 39 patients; diseases were mainly rheumatoid arthritis (n = 20), primary Sjögren’s syndrome (n = 17), and inflammatory myopathies (n = 7). The diagnosis of CTD-ILD was associated with the presence of musculoskeletal symptoms and immunological and US abnormalities. The CTD diagnosis led to a therapeutic change in 21 patients.

Conclusion: Our findings suggest that musculoskeletal symptoms are frequent in ILD patients, which supports multidisciplinary management, involving the rheumatologist, for evaluating patients with ILD.

目的：间质性肺病（ILD）是结缔组织病（CTD）的共同特征。CTD-ILD 的诊断可能具有挑战性，并且对于治疗决策很重要。在这项研究中，我们旨在确定系统的风湿病学评估是否可以帮助肺科医生诊断和护理 ILD 患者。

方法：我们对 ILD 患者进行了一项观察性单中心研究。所有患者都接受了标准化的肺部和风湿病学评估，包括临床评估（肺部症状和肌肉骨骼体征）、免疫学筛查、胸部高分辨率计算机断层扫描、肺功能检查以及关节和主要唾液腺的超声检查（US）。

结果：我们纳入了 100 名连续的 ILD 患者（47% 的女性，平均 ± sd 年龄 67 ± 14 岁）；15 名患者已经患有 CTD。主要的肺外症状是关节疼痛（n = 52）、关节肿胀（n = 26）和干燥综合征（n = 33）。关节超声显示分别有 37、17 和 13 名患者出现滑膜炎、骨侵蚀和腱鞘炎。13 名患者的主要唾液腺超声检测到与干燥综合征相关的特征。经风湿病学评估，39 例患者确诊 CTD-ILD；疾病主要是类风湿性关节炎（n = 20）、原发性干燥综合征（n = 17）和炎症性肌病（n = 7）。CTD-ILD 的诊断与肌肉骨骼症状以及免疫学和超声异常的存在有关。CTD 诊断导致 21 名患者的治疗改变。

结论：我们的研究结果表明 ILD 患者经常出现肌肉骨骼症状，这支持多学科管理，包括风湿病学家，以评估 ILD 患者。