Table 6.

Identification and monitoring of SSc-ILD.

	Signs and symptoms*	Spirometry and DLCO	HRCT
Baseline/diagnosis time	Check	Yes	Yes
Follow-up in patients without a known ILD	Check at every examination	Every 6–12 months or in case of onset of respiratory signs or symptoms∧	Every 24 months Every 12 months in presence of risk factorsa
Follow-up in patients with a known ILD	Check at every examination NB: Worsening of symptoms are suggestive of ILD progression or complications°	Every 6–12 months, or every 3–6 months, if risk factorsa are present	To be performed every 12 months according to clinical status In case of rapid deterioration, re-evaluate the timing

^aRisk factors should be assessed at every examination. Risk factors include male gender, diffuse skin disease, and presence of anti-Scl70 antibodies.

^*Presence of basal velcro crackles, dry cough and exertional dyspnea, not justified by a respiratory infection or cardiological pathology in progress.

^°Infection, cancer, heart failure, drug toxicity.

^∧Do not delay spirometry if DLCO is not available in a short time.