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Radiol Bras. 2016 Set/Out;49(5):VII–VIII Involvement of the respiratory system is quite common in the course of systemic sclerosis (SSc) and can affect all its components, including the parenchyma, vasculature, airways, pleura, and muscle tissue. However, the forms that are the most common and have the greatest clinical repercussions are interstitial lung disease (ILD) and pulmonary arterial hypertension, which account for up to 90% and 60% of cases, respectively. The presence of a pulmonary lesion is a determining factor in the quality of life of patients with SSc and currently represents the main cause of SScrelated mortality, especially among patients diagnosed with ILD. The onset of SSc-ILD is insidious, with subtle clinical symptoms, which explains why the disease is often diagnosed in its advanced stages, when extensive pulmonary fibrosis is already present. Targeted strategies to identify the risk of SSc-ILD at the beginning of its course are fundamental, because such strategies can allow the early introduction of treatment. The importance of differentiating histological patterns in SScILD is that it determines the prognosis, which is better in cases of nonspecific interstitial pneumonia and worse in those of usual interstitial pneumonia. However, in clinical practice, conducting routine lung biopsy is not recommended, being reserved for atypical clinical presentations and tomography findings. In this issue of Radiologia Brasileira, Bastos et al. provide an interesting review in which they emphasize the importance of high-resolution computed tomography (HRCT) and discuss the main tomography patterns of lung disease in SSc. The use of HRCT, in conjunction with pulmonary function tests, plays a critical role in the evaluation of the treatment and prognosis of SSc-ILD. The HRCT method is more precise in differentiating between airway abnormalities and changes that occur in the parenchyma, even allowing the quantitative assessment of lung disease. It is considered the gold standard in the investigation of SSc-ILD, with a sensitively > 90%, given that the accuracy of clinical and functional assessments is

Is computed tomography the ideal method for the identification and management of lung disease in systemic sclerosis?