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From an abdominal ultrasound to a lung disease passing through the diaphragm: a case of idiopathic pulmonary fibrosis

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Abstract

Rationale

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease characterized by abnormal and excessive deposition of collagen in the pulmonary interstitium (fibrosis) with minimal associated inflammation evolving into progressive and irreversible decline in lung function.

Patient concerns

Patient referred discomfort, bilateral upper quadrant abdominal pain, and progressive exertional dyspnea (shortness of breath with exercise).

Diagnosis

Exertional dyspnea due to idiopathic pulmonary fibrosis (IPF).

Intervention

Sonographic evaluation demonstrated an alteration of diaphragm excursion together with a relevant alteration of the pleural line and multiple irregular and confluent B lines.

Conclusions

Lung and diaphragm ultrasound could be employed as a screening or first-line diagnostic tool in the suspicion of interstitial lung disease.

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References

  1. Shirakawa T, Fukuda K, Miyamoto Y, Tanabe H, Tada S (1994) Parietal pleural invasion of lung masses: evaluation with CT performed during deep inspiration and expiration. Radiology 192(3):809–811

    Article  CAS  Google Scholar 

  2. Gierada DS, Curtin JJ, Erickson SJ, Prost RW, Strandt JA, Goodman LR (1995) Diaphragmatic motion: fast gradient-recalled-echo MR imaging in healthy subjects. Radiology 194:879–884

    Article  CAS  Google Scholar 

  3. He L, Zhang W, Zhang J, Cao L, Gong L, Ma J et al (2014) Diaphragmatic motion studied by M-mode ultrasonography in combined pulmonary fibrosis and emphysema. Lung 192:553–561

    Article  Google Scholar 

  4. Zanforlin A, Giannuzzi R, Nardini S, Testa A, Soldati G, Copetti R et al (2013) The role of chest ultrasonography in the management of respiratory disease: document I. Multidiscip Respir Med 8:54

    Article  Google Scholar 

  5. Boussuges A, Gole Y, Blanc P (2009) Diaphragmatic motion studied by M-mode ultrasonography. Chest 135:391–400

    Article  Google Scholar 

  6. Soldati G, Demi M (2017) The use of lung ultrasound images for the differential diagnosis of pulmonary and cardiac interstitial pathology. J Ultrasound. 20(2):91–96. https://doi.org/10.1007/s40477-017-0244-7(eCollection 2017 Jun)

    Article  PubMed  PubMed Central  Google Scholar 

  7. Raghu G, Collard HR, Egan JJ, Martinez FJ, Behr J, Brown KK et al (2011) An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 183:788–824

    Article  Google Scholar 

  8. Testa A, Soldati G, Giannuzzi R, Berardi S, Portale G, Gentiloni SN (2011) Ultrasound M-mode assessment of diaphragmatic kinetics by anterior transverse scanning in healthy subjects. Ultrasound Med Biol 37(1):44–52. https://doi.org/10.1016/j.ultrasmedbio.2010.10.004

    Article  PubMed  Google Scholar 

  9. Boccatonda A, Decorato V, Cocco G, Marinari S, Schiavone C (2018) Ultrasound evaluation of diaphragmatic mobility in patients with idiopathic lung fibrosis: a pilot study. Multidiscip Respir Med. 14(14):1. https://doi.org/10.1186/s40248-018-0159-y(eCollection 2019)

    Article  PubMed  PubMed Central  Google Scholar 

  10. Zanforlin A, Smargiassi A, Inchingolo R, Valente S, Ramazzina E (2014) Ultrasound in obstructive lung diseases: the effect of airway obstruction on diaphragm kinetics A short pictorial essay. J Ultrasound. 18(4):379–384. https://doi.org/10.1007/s40477-014-0122-5(eCollection 2015 Dec)

    Article  PubMed  PubMed Central  Google Scholar 

  11. Shaikh H, Laghi F (2019) Role of diaphragm ultrasound when NIV fails in COPD exacerbations. Respir Care 64(12):1600–1602. https://doi.org/10.4187/respcare.07523

    Article  PubMed  Google Scholar 

  12. Santana PV, Cardenas LZ, de Albuquerque ALP, de Carvalho CRR, Caruso P (2019) Diaphragmatic ultrasound findings correlate with dyspnea, exercise tolerance, health-related quality of life and lung function in patients with fibrotic interstitial lung disease. BMC Pulm Med 19(1):183. https://doi.org/10.1186/s12890-019-0936-1

    Article  PubMed  PubMed Central  Google Scholar 

  13. Cammarota G, Sguazzotti I, Zanoni M, Messina A, Colombo D et al (2019) Diaphragmatic ultrasound assessment in subjects with acute hypercapnic respiratory failure admitted to the emergency department. Respir Care. 64(12):1469–1477. https://doi.org/10.4187/respcare.06803(Epub 2019 Aug 27)

    Article  PubMed  Google Scholar 

  14. Perrone T, Quaglia F (2017) Lung US features of severe interstitial pneumonia: case report and review of the literature. J Ultrasound 20(3):247–249. https://doi.org/10.1007/s40477-017-0241-x

    Article  PubMed  PubMed Central  Google Scholar 

  15. Orso D, Ban A, Guglielmo N (2018) Lung ultrasound in diagnosing pneumonia in childhood: a systematic review and meta-analysis. J Ultrasound 21(3):183–195. https://doi.org/10.1007/s40477-018-0306-5

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rea G, Sperandeo M, Di Serafino M, Vallone G, Tomà P (2019) Neonatal and pediatric thoracic ultrasonography. J Ultrasound 22(2):121–130. https://doi.org/10.1007/s40477-019-00357-6

    Article  PubMed  PubMed Central  Google Scholar 

  17. Sperandeo M, Frongillo E, Dimitri LMC, Simeone A, De Cosmo S, Taurchini M, Cipriani C (2020) Video-assisted thoracic surgery ultrasound (VATS-US) in the evaluation of subpleural disease: preliminary report of a systematic study. J Ultrasound 23(1):105–112. https://doi.org/10.1007/s40477-019-00374-5

    Article  PubMed  Google Scholar 

  18. Merli L, Nanni L, Curatola A, Pellegrino M, De Santis M, Silvaroli S, Paradiso FV, Buonsenso D (2019) Congenital lung malformations: a novel application for lung ultrasound? J Ultrasound. https://doi.org/10.1007/s40477-019-00406-0

    Article  PubMed  Google Scholar 

  19. Boccatonda A, Primomo G, Cocco G, D'Ardes D, Marinari S, Montanari M, Giostra F, Schiavone C (2020) Not all abolished lung sliding are pneumothorax: the case of a particular lung atelectasis. J Ultrasound. https://doi.org/10.1007/s40477-020-00427-0

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Andrea Boccatonda.

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Boccatonda, A., Liberatore, I., Cocco, G. et al. From an abdominal ultrasound to a lung disease passing through the diaphragm: a case of idiopathic pulmonary fibrosis. J Ultrasound 23, 607–611 (2020). https://doi.org/10.1007/s40477-020-00445-y

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