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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, Dergaa I. Assessment Tools for Pulmonary Involvement in Patients with Ankylosing Spondylitis: Is Diaphragmatic Ultrasonography Correlated to Spirometry? J Multidiscip Healthc 2023; 16:51-61. [PMID: 36660040 PMCID: PMC9843477 DOI: 10.2147/jmdh.s393061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/23/2022] [Indexed: 01/12/2023] Open
Abstract
Objective 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.
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Affiliation(s)
- Rim Dhahri
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Islam Mejri
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia
| | - Amine Ghram
- Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Research Laboratory “Heart Failure, LR12SP09”, Hospital Farhat HACHED of Sousse, Sousse, Tunisia
| | - Abir Dghaies
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Marwa Slouma
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Soumaya Boussaid
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA,Department of Rheumatology, Rabta Hospital, Tunis, Tunisia
| | - Leila Metoui
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Imen Gharsallah
- Department of Rheumatology, Military Hospital of Instruction, Tunis, Tunisia,University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Khadija Ayed
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Aviation Medicine Center of Expertise, Tunis, Tunisia
| | - Zied Moatemri
- University of Tunis el Manar, Faculty of Medicine of Tunis, Tunis, Tunisia,Department of Pneumology, Military Hospital of instruction, Tunis, Tunisia
| | | | | | - Ismail Dergaa
- Primary Health Care Corporation (PHCC), Doha, Qatar,Research Unit Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia,High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia,Correspondence: Ismail Dergaa, Primary Health Care Corporation (PHCC), Doha, Qatar, Email ;
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