SSc-ILD or COVID-19 pneumonia? CT features can help in diagnosis

A new study identified computed tomography (CT) features that can help differentiate between interstitial lung disease (ILD) secondary to Systemic sclerosis (SSc) and COVID-19 pneumonia. Radiologists and non-radiologists examined the CT images of 52 patients with COVID-19 and 47 patients with SSc-ILD.

SSc-ILD CT features included:

-Fibrosis inside focal ground glass opacities (GGO) in the upper lobes
-Fibrosis in the lower lobe GGO
-Reticulations in lower lobes

COVID-19 CT features included:

-Consolidation (CONS) in the lower lobes
-CONS with peripheral (both central/peripheral or patchy distributions)
-Anterior and posterior CONS
-Rounded-shaped GGOs in the lower lobes

CONS in the lower lobes was independently associated with COVID-19 pneumonia, whereas signs of fibrosis in GGO in the lower lobes was independently associated with or SSc-ILD.

Reference
Orlandi M, Landini N, Sambataro G, et al The role of chest CT in deciphering interstitial lung involvement: systemic sclerosis versus COVID-19. Rheumatol (Oxford). 2021;keab615. doi: 10.1093/rheumatology/keab615. Epub ahead of print. PMID: 34320649.