With the aim of providing you with information that may be useful in your medical practice, the Guide have summarized the main recommendations of the 2023 American College of Rheumatology Guideline for the Detection and Monitoring of Interstitial Lung Disease (ILD) in individuals with systemic autoimmune disease. Rheumatic disease.
This clinical guideline includes recommendations for the detection of Interstitial Lung Disease (ILD) in patients with Systemic Autoimmune Rheumatic Diseases (SARDs) [Rheumatoid Arthritis (RA), Systemic Sclerosis (SSc), Idiopathic Inflammatory Myositis (IIM, including polymyositis, dermatomyositis, antisynthetase syndrome, immune-mediated necrotizing myopathy), Mixed Connective Tissue Disease (MCTD), and Sjögren’s Disease (SjD)] associated with the greatest risk of ILD, and for monitoring ILD progression. The Guide hope you find it helpful.
By America Torres
Recommendations for the detection of SARD-associated Interstitial Lung Disease
- For patients with SARDs at increased risk of developing Interstitial Lung Disease (ILD), the Guide conditionally recommends screening with PFTs (Pulmonary Function Tests).
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends screening with High-resolution computed tomography (HRCT) of the chest.
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends screening with HRCT chest and PFTs over PFTs alone.
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends against screening with 6-minute walking distance (6 MWD).
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends against screening with chest radiography.
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends against screening with ambulatory desaturation testing.
- For patients with SARDs at increased risk of developing ILD, the Guide conditionally recommends against screening with bronchoscopy.
- For patients with SARDs at increased risk of developing ILD, the Guide strongly recommends against screening with surgical lung biopsy.
Recommendations for Monitoring the Progression of Interstitial Lung Disease
- For patients with SARDs-ILD, the Guide conditionally recommends monitoring with PFTs.
- For patients with SARDs-ILD, the Guide conditionally recommends monitoring with HRCT chest.
- For patients with SARDs-ILD, the Guide conditionally recommends monitoring with PFTs and HRCT chest over PFTs alone.
- For patients with SARDs-ILD, the Guide conditionally recommends monitoring with ambulatory desaturation testing.
- For patients with SARDs-ILD, the Guide conditionally recommends against monitoring with chest radiography.
- For patients with SARDs-ILD, the Guide conditionally recommends against monitoring with 6MWD.
- For patients with SARDs-ILD, the Guide conditionally recommends against monitoring with bronchoscopy.
- For patients with IIM-ILD and SSc-ILD, the Guide suggest PFTs for monitoring every 3-6 months rather than either shorter or longer intervals, for the first year, then less frequently once stable.
- For patients with RA-ILD, SjD-ILD, and MCTD-ILD, the Guide suggest PFTs for monitoring every 3-12 months rather than shorter or longer intervals, for the first year, then less frequently once stable.
- For patients with SARDs-ILD, the Guide do not provide guidance about frequency of routine HRCT chest for monitoring ILD but suggest HRCT when clinically indicated.
- For patients with SARDs-ILD, the Guide suggest assessment for ambulatory desaturation every 3-12 months rather than at shorter or longer intervals.
Conclusion
In summary, the 2023 American College of Rheumatology Guidelines for the Detection and Monitoring of Interstitial Lung Disease in individuals with systemic autoimmune disease and rheumatic disease conditionally recommends the following screening tests:
- Pulmonary Function Tests: spirometry, lung volume, and diffusion capacity.
- High-resolution computed tomography of the chest.
Likewise, this document conditionally recommends these Pulmonary Function Tests: spirometry, lung volumes, and diffusion capacity in the following cases:
- For idiopathic inflammatory myopathy (IIM): every 3-6 months in the first year. Then less frequently, once the patient is stable.
- For systemic sclerosis: every 3-6 months in the first year. Then less frequently once the patient is stable.
- For rheumatoid arthritis, Sjögren’s syndrome, mixed connective tissue disease: every 3-12 months in the first year. Then less frequently once the patient is stable.
It also conditionally recommends ambulatory desaturation testing every 3-12 months (this test can be performed during routine visits or as part of the 6-minute walking distance test). Chest computed tomography is conditionally recommended as needed.
Advanced solutions for diagnosing and monitoring interstitial lung disease
At SCHILLER-GANSHORN, we provide cutting-edge solutions for diagnosing and monitoring respiratory conditions, such as asthma, COPD, and interstitial lung disease, with unmatched accuracy and reliability. Each solution is built with precision, efficiency, and patient comfort in mind—powered by our signature SharpFlow ultrasonic technology and seamlessly integrated with LFX software.
Our devices are fully equipped to perform the tests recommended by the 2023 American College of Rheumatology Guidelines for the Detection and Monitoring of Interstitial Lung Disease, helping clinicians detect disease early, monitor progression, and assess treatment response with confidence. Here’s a closer look at our key devices and how they support your ILD diagnostic workflow.
Spirometry. We offer the ultrasonic spirometer, SpiroScout, which requires no calibration and avoids cross-contamination thanks to its single-use disposable ScoutTube mouthpieces. Additionally, it features LFX software, which allows for quick report generation and comparison of patient tests for reliable monitoring.
SCHILLER Trial Program. This program is designed to let you try the SpiroScout completely free of charge in your practice. We invite you to use it in your daily workflow and experience firsthand how this easy-to-use device can enhance your efficiency.
How the SCHILLER Trial Program works. You can try the SpiroScout for 15 business days. At the end of the trial period, you can choose to purchase and keep it—or simply return it. No questions asked, no obligation.
6-minute walk test. Our solution, the Diagnostic Station DS-20, not only monitors vital signs but also performs electrocardiograms, including the 6-minute walk test. The DS-20 is a unique device on the market that combines key vital signs and physical assessment tools in a single system—such as NIBP, TEMP, SpO₂, and 3-lead ECG. This innovative, high-performance device was developed to enhance and simplify the workflow of physicians and nurses in hospitals, emergency rooms, triage areas, and doctors’ offices. Additionally, it supports CPT code 94618 for the 6-minute walk test, which includes heart rate measurement, oximetry, and ECG ST segment analysis when performed.
The Diagnostic Station DS-20 is also available through the SCHILLER Trial Program. Request a free trial and discover how it can streamline workflow in triage, enhance patient care, and reduce staff workload.
At SCHILLER-GANSHORN, our mission is to support clinicians in safeguarding their patients’ lung health by providing diagnostic tools aligned with leading clinical guidelines. We understand that every practice is unique—that’s why we offer free, personalized demonstrations to help you explore the solutions best suited to your needs. Don’t hesitate to request your no-obligation one-on-one session and discover how SCHILLER-GANSHORN can make a difference in your ILD diagnostic workflow.
