“Velcro-type” crackles predict specific radiologic features of fibrotic interstitial lung disease
Open accessAbstract
BACKGROUND: "Velcro-type" crackles on chest auscultation are considered a typical acoustic finding of Fibrotic Interstitial Lung Disease (FILD), however whether they may have a role in the early detection of these disorders has been unknown. This study investigated how "Velcro-type" crackles correlate with the presence of distinct patterns of FILD and individual radiologic features of pulmonary fibrosis on High Resolution Computed Tomography (HRCT). METHODS: Lung sounds were digitally recorded from subjects immediately prior to undergoing clinically indicated chest HRCT. Audio files were independently assessed by two chest physicians and both full volume and single HRCT sections corresponding to the recording sites were extracted. The relationships between audible "Velcro-type" crackles and radiologic HRCT patterns and individual features of pulmonary fibrosis were investigated using multivariate regression models. RESULTS: 148 subjects were enrolled: bilateral "Velcro-type" crackles predicted the presence of FILD at HRCT (OR 13.46, 95% CI 5.85-30.96, p < 0.001) and most strongly the Usual Interstitial Pneumonia (UIP) pattern (OR 19.8, 95% CI 5.28-74.25, p < 0.001). Extent of isolated reticulation (OR 2.04, 95% CI 1.62-2.57, p < 0.001), honeycombing (OR 1.88, 95% CI 1.24-2.83, < 0.01), ground glass opacities (OR 1.74, 95% CI 1.29-2.32, p < 0.001) and traction bronchiectasis (OR 1.55, 95% CI 1.03-2.32, p < 0.05) were all independently associated with the presence of "Velcro-type" crackles. CONCLUSIONS: "Velcro-type" crackles predict the presence of FILD and directly correlate with the extent of distinct radiologic features of pulmonary fibrosis. Such evidence provides grounds for further investigation of lung sounds as an early identification tool in FILD.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Velcro-like crackles on chest auscultation are a common and early indication of IPF and closely correlate with the extent of several HRCT features, including honeycombing and reticulation.
“Velcro-like crackles on chest auscultation are a common and early indication of IPF and they closely correlate with the extent of several HRCT features, including honeycombing and reticulation.”
From Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies (2023) · cites this paper as Sgalla et al., 2018
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Raghu, G., Collard, H. R., Egan, J. J., Martinez, F. J., Behr, J., Brown, K. K., Colby, T. V., Cordier, J.-F., Flaherty, K. R., Lasky, J. A., et al. (2011) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2009-040gl · Cited by 7,186 · see citing works
Self-citationTravis, W. D., Costabel, U., Hansell, D. M., King, T. E., Lynch, D. A., Nicholson, A. G., Ryerson, C. J., Ryu, J. H., Selman, M., Wells, A. U., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201308-1483st · Cited by 4,320 · see citing works
Self-citationFleischner Society: Glossary of Terms for Thoracic Imaging
Hansell, D. M., Bankier, A. A., MacMahon, H., McLoud, T. C., Müller, N. L., & Rémy, J. (2008) · Radiology · doi:10.1148/radiol.2462070712 · Cited by 4,189 · see citing works
Richeldi, L., Collard, H. R., & Jones, M. G. (2017) · The Lancet · doi:10.1016/s0140-6736(17)30866-8 · Cited by 2,020 · see citing works
Self-citationStatistical methods for assessing observer variability in clinical measures.
Brennan, P., & Silman, A. J. (1992) · BMJ · doi:10.1136/bmj.304.6840.1491 · Cited by 984 · see citing works
Fundamentals of Lung Auscultation
Bohadana, A., Izbicki, G., & Kraman, S. S. (2014) · New England Journal of Medicine · doi:10.1056/nejmra1302901 · Cited by 482 · see citing works
Kazerooni, E. A., Martínez, F. J., Flint, A., Jamadar, D. A., Gross, B. H., Spizarny, D. L., Cascade, P. N., Whyte, R. I., Lynch, J. P., & Toews, G. (1997) · American Journal of Roentgenology · doi:10.2214/ajr.169.4.9308447 · Cited by 468 · see citing works
Forgacs, P. (1967) · The Lancet · doi:10.1016/s0140-6736(67)90024-4 · Cited by 152 · see citing works
Velcro crackles: the key for early diagnosis of idiopathic pulmonary fibrosis?
Cottin, V., & Cordier, J.-F. (2012) · European Respiratory Journal · doi:10.1183/09031936.00001612 · Cited by 134 · see citing works
Towards the standardisation of lung sound nomenclature
Pasterkamp, H., Brand, P. L. P., Everard, M. L., et al. (2015) · European Respiratory Journal · doi:10.1183/13993003.01132-2015 · Cited by 134 · see citing works
Comparison of the acoustic properties of six popular stethoscopes
Abella, M., Formolo, J. M., & Penney, D. G. (1992) · The Journal of the Acoustical Society of America · doi:10.1121/1.403655 · Cited by 110 · see citing works
Oda, K., Ishimoto, H., Yatera, K., Naito, K., Ogoshi, T., Yamasaki, K., Imanaga, T., Tsuda, T., Nakao, H., Kawanami, T., et al. (2014) · Respiratory Research · doi:10.1186/1465-9921-15-10 · Cited by 106 · see citing works
Cottin, V., & Richeldi, L. (2014) · European Respiratory Review · doi:10.1183/09059180.00008613 · Cited by 88 · see citing works
Self-citationNeglected evidence in idiopathic pulmonary fibrosis: from history to earlier diagnosis
Cordier, J.-F., & Cottin, V. (2013) · European Respiratory Journal · doi:10.1183/09031936.00027913 · Cited by 76 · see citing works
Automated Analysis of Crackles in Patients with Interstitial Pulmonary Fibrosis
Flietstra, B. C., Markuzon, N., Vyshedskiy, A., et al. (2010) · Pulmonary Medicine · doi:10.1155/2011/590506 · Cited by 62 · see citing works
Auscultation of Velcro Crackles is Associated With Usual Interstitial Pneumonia
Sellarés, J., Hernández‐González, F., Lucena, C. M., et al. (2016) · Medicine · doi:10.1097/md.0000000000002573 · Cited by 60 · see citing works
Discrete lung sounds: Crackles (rales) as stress–relaxation quadrupoles
Fredberg, J. J., & Holford, S. K. (1983) · The Journal of the Acoustical Society of America · doi:10.1121/1.389151 · Cited by 56 · see citing works
Vyshedskiy, A., Bezares, F., Paciej, R., et al. (2005) · CHEST Journal · doi:10.1378/chest.128.3.1468 · Cited by 37 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Spectrum of fibrotic lung diseases
Wijsenbeek, M., & Cottin, V. (2020) · New England Journal of Medicine · doi:10.1056/nejmra2005230 · Cited by 736 · see citing works
Pulmonary fibrosis: Emerging diagnostic and therapeutic strategies
Selvarajah, B., Platé, M., & Chambers, R. C. (2023) · Molecular Aspects of Medicine · doi:10.1016/j.mam.2023.101227 · Cited by 57 · see citing works
Sgalla, G., Larici, A. R., Sverzellati, N., Bartholmai, B., Walsh, S. L. F., Nikolic, D., Barney, A., Fletcher, S., Jones, M., Davies, D. D., et al. (2019) · European Respiratory Journal · doi:10.1183/13993003.02093-2018 · Cited by 15 · see citing works
Self-citation
- Authors
- Sgalla, G., Walsh, S. L. F., Sverzellati, N., Fletcher, S., Cerri, S., Dimitrov, B., Nikolic, D., Barney, A., Pancaldi, F., Larcher, L., Luppi, F., Jones, M. G., Davies, D., & Richeldi, L.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- King's College Hospital (GB)
- University of Parma (IT)
- National Institute for Health and Care Research (GB)
- Azienda Ospedaliero-Universitaria di Modena (IT)
- University of Southampton (GB)
- University of Modena and Reggio Emilia (IT)
- Corresponding author
- Sgalla, Giacomo
- ORCID
- Venue
- BMC Pulmonary Medicine
- Published
- 2018-06-18
- Volume
- 18
- Issue
- 1
- Pages
- 103-103
- ISSN
- 1471-2466 (ISSN-L)
- PMC
- PMC6006991
- OpenAlex
- W2809016819
- Cited by
- 76
- References
- 18
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 7 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 10 · 2019: 10 · 2018: 1
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pulmonary Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- BOA (University of Milano-Bicocca) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IRIS UNIMORE (University of Modena and Reggio Emilia) (submittedVersion, other-oa)
- Funders
- Intermune UK
- Intermune Europe
- Wellcome Trust (100638/Z/12/Z, 109682MA)
- NIHR Southampton Biomedical Research Unit
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Phonocardiography and Auscultation Techniques
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Keywords
- fibrotic interstitial lung disease, pulmonary fibrosis, usual interstitial pneumonia, lung auscultation, high-resolution computed tomography, honeycombing, traction bronchiectasis, ground-glass opacities, early detection, lung sounds
- MeSH terms
- Aged, Auscultation, Female, Humans, Italy, Lung, Male, Middle Aged, Prospective Studies, Respiratory Sounds, Tomography, X-Ray Computed, Multivariate Analysis, Logistic Models, Lung Diseases, Interstitial, Idiopathic Pulmonary Fibrosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
