Lung findings on high-resolution computed tomography in idiopathic ankylosing spondylitis--correlation with clinical findings, pulmonary function testing and plain radiography

Abstract

Previous studies on the association of ankylosing spondylitis and abnormalities of the lung parenchyma have been based largely on plain radiography and pulmonary function testing. This study, although uncontrolled, is the first to use high-resolution computed tomography to examine the entire lung parenchyma in ankylosing spondylitis patients, and to correlate the findings with clinical assessment, plain radiography and pulmonary function testing. The study population comprised 26 patients meeting the New York criteria for idiopathic ankylosing spondylitis who attended the out-patient department at our institution. High-resolution computed tomography examination revealed abnormalities in 19 patients (70%): these included interstitial lung disease (n = 4), bronchiectasis (n = 6), emphysema (n = 4), apical fibrosis (n = 2), mycetoma (n = 1) and non-specific interstitial lung disease (n = 12). Plain radiography was abnormal in only four patients and failed to identify any patient with interstitial lung disease. All patients with interstitial lung disease on high-resolution computed tomography had respiratory symptoms and three of the four had evidence of a restrictive process on pulmonary function testing. This study raises, for the first time, the possible association between interstitial lung disease and ankylosing spondylitis, and highlights the use of high-resolution computed tomography in detecting such disease in ankylosing spondylitis patients.

The Pulmonary Involvement in Rheumatic Diseases: Pulmonary Effects of Ankylosing Spondylitis and Its Impact on Functionality and Quality of Life

“…In contrast to our study, they did not find any correlation between PFT and thoracic expansion. Casserly et al (1997) reported that the patients who had PFT abnormality shown abnormal HRCT changes and there was a statistically significant correlation with HRCT and PFT findings.…”

The Effect of Breathing and Posture Exercise on the Clinical, Functional Status and Disease Related Quality of Life in Patients with Ankylosing Spondylitis

“…Fundamental changes are apical fibrobullous changes, interstitial lung disease, pleural thickening, and effusion [2,3]. The thoracal movements may be restricted due to the involvement of the thoracic, costovertebral, manubriosternal and costosternal vertebrae, and the effect of postural factors along with the sacroiliac joint involvement, sometimes lead to restrictive respiratory distress [4].…”

“…In clinical applications, the chest expansion measurement, costochondral joint tenderness, chest X-ray, carbon monoxide diffusion capacity, lung function tests, bronchoalveolar lavage, high-resolution tomography of the lung and transbronchial biopsy all can be used to assess the respiratory system involvement in patients [3].…”

Atividade física regular preserva a função pulmonar em pacientes com espondilite anquilosante sem doença pulmonar prévia

“…[3][4][5] Considering that there is no definitive treatment for AS and the main goals are to educate and make patient aware of his/her participation in an exercise program so that he/she can keep a functional posture and also maintain movements, this research is a transversal study aiming at comparing patients with AS and verifying the effect of moderate regular physical activity in these patients' respiratory capacity. [4][5][6][7][8] …”