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PubMed This is a summary of 9 peer-reviewed journal articles Updated
Pulmonology

How Often Are PFTs and CTs for Antisynthetase Syndrome?

At a Glance

For people with antisynthetase syndrome and lung disease, breathing tests are usually done every 3–6 months when disease is new, active, or treatment is changing, then every 6–12 months when stable. CT scans are repeated only when symptoms or test results suggest they are needed.

In this answer

3 sections

01

Pulmonary Function Tests (PFTs) and Oxygen Tests

02

High-Resolution CT Scans (HRCT)

03

When to Seek Immediate Care

If you have interstitial lung disease (ILD) associated with antisynthetase syndrome, your medical team will monitor your lung health using a combination of breathing tests and imaging. The American College of Rheumatology (ACR) and the American College of Chest Physicians (CHEST) conditionally recommend regular monitoring with pulmonary function tests (PFTs) and tests to see if your oxygen drops when you walk, while high-resolution computed tomography (HRCT) scans of the chest are used when clinically indicated [1][2].

Generally, you can expect to have PFTs every 3 to 6 months when your ILD is newly diagnosed, active, or when adjusting treatments, and then about once a year when your condition is stable [1][3]. CT scans are usually done to establish a baseline when ILD is suspected or confirmed, and then selectively repeated—not on a strict annual schedule—to limit your exposure to radiation [4][5].

Pulmonary Function Tests (PFTs) and Oxygen Tests

Pulmonary Function Tests (PFTs) are non-invasive breathing tests that measure airflow, lung volume, and gas exchange. They are a key tool for tracking your lung health over time.

  • Forced Vital Capacity (FVC): This measures the amount of air you can forcefully exhale after taking a maximal inhalation.
  • DLCO: This estimates how efficiently your lungs transfer gas into your bloodstream.

In addition to PFTs, your doctor may check your oxygen levels while you walk, known as ambulatory desaturation testing. This usually involves wearing a pulse oximeter on your finger while walking in the clinic to see if your oxygen levels drop during exertion [1].

Because lung involvement in antisynthetase syndrome can change, standard clinical practice is to perform PFTs frequently during the early stages of the disease:

  • Active or New ILD: When you are newly diagnosed with lung involvement, experiencing a flare-up, or starting a new medication, your doctor will likely order PFTs every 3 to 6 months [1][3].
  • Stable Disease: Once your symptoms are controlled and your lung function is steady, the frequency usually decreases to every 6 to 12 months, often annually [1].

Understanding Your Results

Watching for trends in your PFT results is important. In one study of patients with antisynthetase syndrome, a relative decline in FVC of just 5% over one year was associated with worse long-term outcomes [3]. More broadly across connective tissue disease-associated ILDs, doctors often consider a relative drop in FVC of 10% or more, or a 5% to 9% drop in FVC combined with a 15% drop in DLCO, as a sign of clinically meaningful disease progression [6].

However, no single threshold is universally applied. A single PFT can vary based on your effort that day, testing conditions, or other factors like anemia or infection. Clinicians look at confirmed trends alongside your symptoms and oxygen levels rather than relying on one test to change your treatment [6].

It is also vital to know that your lung disease can progress even if your muscle or joint symptoms have completely resolved [7]. Therefore, regular lung monitoring must continue even when your body feels well.

High-Resolution CT Scans (HRCT)

A High-Resolution Computed Tomography (HRCT) scan provides detailed, cross-sectional images of your lungs. Unlike PFTs, which show how your lungs function, an HRCT shows what your lungs look like and can identify inflammation or scarring.

  • At Baseline: When ILD is first suspected or confirmed, an HRCT is commonly used to establish a baseline and identify the specific pattern of lung involvement [4].
  • Follow-Up Scans: Routine, yearly CT scans are not standard practice. To minimize unnecessary exposure to radiation, doctors selectively order repeat HRCT scans when clinically indicated [5].

Your doctor will likely order a follow-up HRCT if:

  • Your PFT results show a confirmed, concerning decline [5][8].
  • You develop new or worsening lung symptoms that do not match your PFT results.
  • Your doctor needs to evaluate if a specific treatment is working [9].

By combining scheduled PFTs with selective CT scans, your care team gets a complementary picture of your lung health while keeping you safe from excess radiation.

When to Seek Immediate Care

Do not wait for your next scheduled breathing test or CT scan if you experience sudden or severe symptoms. Seek urgent medical assessment or emergency care if you develop:

  • Rapidly worsening shortness of breath
  • Chest pain or fainting
  • Blue lips or fingers
  • Markedly low oxygen readings on a home pulse oximeter

New breathlessness can also be caused by infections, heart issues, or blood clots, which require prompt medical attention.

Common questions in this guide

How often should I have PFTs for antisynthetase syndrome?
If lung disease is new, active, flaring, or treatment is changing, PFTs are commonly repeated every 3 to 6 months. When symptoms and lung function are stable, testing often moves to every 6 to 12 months, commonly once a year. Your clinician may adjust the schedule for your situation.
Do I need a CT scan every year for antisynthetase syndrome?
Usually not. A high-resolution CT scan is often used at baseline when interstitial lung disease is suspected or confirmed, then repeated when a confirmed decline in breathing tests, new or worsening symptoms, or a need to assess treatment response makes imaging useful. This selective approach helps limit radiation exposure.
What do PFTs and walking oxygen tests show?
PFTs measure airflow, lung volume, and how efficiently the lungs move gas into the bloodstream; FVC and DLCO are common measures. A walking oxygen test checks whether oxygen levels fall during activity. Together with symptoms, these results help clinicians assess lung health over time.
Can my lung disease worsen even if my muscle and joint symptoms improve?
Yes. Lung involvement can progress even when muscle or joint symptoms have resolved, so scheduled lung monitoring should continue unless your medical team changes the plan.
What breathing-test changes might lead to another CT scan?
A confirmed, concerning decline in lung function may prompt a repeat high-resolution CT scan, especially if it matches worsening symptoms or raises questions about treatment response. Doctors interpret trends in FVC and DLCO alongside symptoms and oxygen levels, so one isolated result does not automatically mean progression.
When should I seek urgent care instead of waiting for my next test?
Seek urgent medical assessment for rapidly worsening shortness of breath, chest pain, fainting, blue lips or fingers, or markedly low oxygen readings at home. New breathing problems can also result from infection, heart problems, or blood clots and should be assessed promptly.

Related questions

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References

References (9)
  1. 1

    2023 American College of Rheumatology (ACR)/American College of Chest Physicians (CHEST) Guideline for the Screening and Monitoring of Interstitial Lung Disease in People with Systemic Autoimmune Rheumatic Diseases.

    Johnson SR, Bernstein EJ, Bolster MB, et al.

    Arthritis care & research 2024; (76(8)):1070-1082 doi:10.1002/acr.25347.

    PMID: 38973729
  2. 2

    Relationship between high-resolution computed tomography quantitative imaging analysis and physiological and clinical features in antisynthetase syndrome-related interstitial lung disease.

    Bae SS, Abtin F, Kim G, et al.

    RMD open 2024; (10(4)) doi:10.1136/rmdopen-2024-004592.

    PMID: 39608864
  3. 3

    Prognostic significance of 1-year pulmonary function changes in inflammatory myopathy-related interstitial lung disease.

    Keret S, Laverde SM, Silva RL, et al.

    Seminars in arthritis and rheumatism 2026; (78()):152957 doi:10.1016/j.semarthrit.2026.152957.

    PMID: 41903313
  4. 4

    Management and outcomes of interstitial lung disease associated with anti-synthetase syndrome: a systematic literature review.

    Kouranloo K, Dey M, Elwell H, et al.

    Rheumatology (Oxford, England) 2025; (64(1)):45-55 doi:10.1093/rheumatology/keae403.

    PMID: 39083028
  5. 5

    Cross-sectional analysis of quantitative computed tomography parameters and pulmonary function in anti-synthetase syndrome-associated interstitial lung disease.

    Wang J, Zhao R, Piao S, et al.

    Clinical and experimental rheumatology 2026; doi:10.55563/clinexprheumatol/lt4tqo.

    PMID: 41930647
  6. 6

    Connective Tissue Disease-associated Interstitial Lung Diseases (CTD-ILD) - Report from OMERACT CTD-ILD Working Group.

    Khanna D, Mittoo S, Aggarwal R, et al.

    The Journal of rheumatology 2015; (42(11)):2168-71 doi:10.3899/jrheum.141182.

    PMID: 25729034
  7. 7

    Clinical Characteristics and Evolution of Interstitial Lung Disease in Subtypes of Idiopathic Inflammatory Myositis With Prevalent Lung Manifestation: A Retrospective Analysis.

    Clark J, Chan D, Dhillon D, et al.

    ACR open rheumatology 2026; (8(2)):e90010 doi:10.1002/acr2.90010.

    PMID: 41610110
  8. 8

    Natural history of indolent-anti-synthetase syndrome-associated interstitial lung disease.

    Moda M, Sumikawa H, Shintani R, et al.

    Respiratory investigation 2024; (62(5)):872-878 doi:10.1016/j.resinv.2024.07.015.

    PMID: 39084070
  9. 9

    Rituximab in the Treatment of Interstitial Lung Disease Associated with Antisynthetase Syndrome: A Multicenter Retrospective Case Review.

    Doyle TJ, Dhillon N, Madan R, et al.

    The Journal of rheumatology 2018; (45(6)):841-850 doi:10.3899/jrheum.170541.

    PMID: 29606668

This page describes general monitoring for antisynthetase syndrome-associated interstitial lung disease for informational purposes only and does not replace medical advice. Your pulmonology and rheumatology teams should set your PFT and CT schedule based on your symptoms, results, and treatment.