High resolution computed tomography of the lungs in patients with rheumatoid arthritis

Abstract

Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis (RA). The aim of this prospective study was to assess pulmonary involvement with high resolution computerized tomography (HRCT) in lifelong non-smoking patients with RA. Twenty-six female and eight male patients with a mean age of 45.26 +/- 11.6 years and without any evidence or symptoms of a respiratory disease were included in the study. Data were obtained regarding duration of disease, clinical symptoms and disease activity parameters. Standard chest roentgenographs, pulmonary function tests (PFT) and HRCT were performed. PFT was abnormal in eight (23.5%) and HRCT was abnormal in 23 patients (68%). The most frequent abnormalities obtained on HRCT were interstitial involvement including septal and peribronchial thickening and fibronodular infiltration, which were found in 23 patients, and bronchiectasis was found in nine patients. Using a highly sensitive technique such as HRCT the incidence of pulmonary abnormalities in asymptomatic rheumatoid patients may be much higher than previously reported.

Extraarticular manifestations in Turkish patients with rheumatoid arthritis: impact of EAMs on the health-related quality of life in terms of disease activity, functional status, severity of pain, and social and emotional functioning

“…PFT was abnormal in 23.5%, and HRCT was abnormal in 68%. They noted that the incidence of pulmonary abnormalities in asymptomatic RA patients might be higher than previously reported by using a highly sensitive technique such as HRCT [14]. The second one is patient selection criteria.…”

Rheumatoid Arthritis-Associated Interstitial Lung Disease

“…The majority of cases of RA-ILD occur in patients between the ages of 50 and 60 years. While several studies 13,[15][16][17]20 have reported smoking, male gender, and longstanding RA to be risk factors for the development of ILD, other reports 13,14,16,17,19 have not shown any significant associations. In addition, genetic associations (human leukocyte antigen B40 and ␣ 1 -antitrypsin) have been described.…”

“…Studies [12][13][14][15][16][17][18][19] have reported a prevalence as low as 4% and as high as 68%. The majority of cases of RA-ILD occur in patients between the ages of 50 and 60 years.…”

Correlation between HRCT findings, pulmonary function tests and bronchoalveolar lavage cytology in interstitial lung disease associated with rheumatoid arthritis

“…This recruitment bias explains the high prevalence of pathological findings in 92% of our HRCT scans. Depending on selection criteria, other authors reported a prevalence of ILD ranging from 19 [9] to 71% [9,10,11,12,13,14] in patients with RA. Previous studies on ILD associated with RA and collagen vascular diseases have clearly demonstrated the superior sensitivity of HRCT compared with common chest X-rays [1,9,12,15]; thus, studies based on common chest X-rays alone revealed prevalences of 2-10% [10,11,16].…”