1. Assessment Tools for Pulmonary Involvement in Patients with Ankylosing Spondylitis: Is Diaphragmatic Ultrasonography Correlated to Spirometry?
- Author
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Dhahri R, Mejri I, Ghram A, Dghaies A, Slouma M, Boussaid S, Metoui L, Gharsallah I, Ayed K, Moatemri Z, Farahat RA, AlHamdani A, and Dergaa I
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spondyloarthritis ,ultrasonography ,diaphragm ,restrictive pulmonary disorder ,spirometry ,Medicine (General) ,R5-920 - Abstract
Rim Dhahri,1,2,* Islam Mejri,2,3,* Amine Ghram,3– 5 Abir Dghaies,1,2 Marwa Slouma,1,2 Soumaya Boussaid,2,4,6 Leila Metoui,1,2 Imen Gharsallah,1,2 Khadija Ayed,2,7 Zied Moatemri,2,3 Ramadan Abdelmoez Farahat,8,* Ahmad AlHamdani,9,* Ismail Dergaa9– 11,* 1Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia; 2University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia; 3Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia; 4Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; 5Research Laboratory “Heart Failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia; 6Department of Rheumatology, Rabta Hospital, Tunis, Tunisia; 7Aviation Medicine Center of Expertise, Tunis, Tunisia; 8Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt; 9Primary Health Care Corporation (PHCC), Doha, Qatar; 10Research Unit Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia; 11High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia*These authors contributed equally to this workCorrespondence: Ismail Dergaa, Primary Health Care Corporation (PHCC), Doha, Qatar, Email Phd.dergaa@gmail.com; idergaa@phcc.gov.qaObjective: Spondyloarthritis (SpA) is a chronic inflammatory rheumatic disease that can lead to spinal ankylosis and consequently, restrictive pulmonary dysfunction. Thus, the present study aimed to assess the accuracy of diaphragm ultrasound compared to spirometry in the screening of restrictive pulmonary disorders in radiographic SpA patients.Methods: We conducted a cross-sectional study of 50 patients with radiographic SpA, over six months. Sociodemographic data, clinical characteristics of the disease, as well as biological, radiological, and therapeutic data, were collected. Spirometry and diaphragm ultrasound were performed.Results: The mean age of the study participants (N= 50) was 42.7± 11 years [range: 25– 66] with male predominance (N= 41). Spirometry showed a restrictive disorder in 32% of cases. The mean chest expansion (CE) value was 3.9± 1.81cm [range: 1– 9] with a median of 4 cm. A pathological value (< 5cm) was observed in 72% of cases. A significant positive correlation was found between the right inspiratory diaphragmatic thickness and forced vital capacity (FVC) (r= 0.36; p = 0.02) and the supine FVC (r=0.29; p = 0.04). The left inspiratory diaphragmatic thickness was correlated with the percentage of the FVC decrease (r= 0.35; p = 0.01) defined as the percentage of difference between FVC and supine FVC. The right expiratory diaphragmatic thickness was associated with the FVC (r=0.32; p = 0.02). A significant positive correlation was found between the CE and the presence of B lines (r=0.32; p = 0.02), but not between the CE and the FVC.Conclusion: The present study showed that diaphragm ultrasonography is correlated with spirometric findings in radiographic SpA patients. Further studies are required to assess its reliability, specificity, and sensitivity in this pathology.Keywords: spondyloarthritis, ultrasonography, diaphragm, restrictive pulmonary disorder, spirometry
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- 2023