Radiological and functional assessment of pulmonary involvement in the rheumatoid arthritis patients

Abstract

The aim was to evaluate the findings of high resolution computed tomography (HRCT) and pulmonary function tests (PFT) in the rheumatoid arthritis (RA) patients with and without pulmonary symptoms and to determine their role in prediction of respiratory system involvement. Among 54 consecutive RA patients, 22 (41%) were symptomatic and 32 (59%) were asymptomatic after detailed respiratory examination. Abnormal findings in PFTs were present in 10 (45%) symptomatic and 15 (47%) asymptomatic patients. PFT results were similar in both groups. A total of 18 (82%) symptomatic and 16 (50%) asymptomatic patients had abnormalities in HRCT scans. About 16 (80%) of 20 patients with normal HRCT scans had no pulmonary symptoms at all and we noted a significant correlation (P < 0.05). HRCT was more useful mean than PFTs in evaluation of pulmonary involvement in the RA patients; however, no correlation was present between various respiratory symptoms and abnormal findings both in PFTs and HRCT scans.

Respiratory symptoms in rheumatoid arthritis: relation to pulmonary abnormalities detected by high-resolution CT and pulmonary functional testing

“…This is in agreement with previous studies [12,30]. In addition, we did not find any relation between HAQ score and lung involvement as most of our patients exerted mild to moderate disease activity and HAQ score.…”

“…Twenty-eight percent of patients showed mixed restrictive and obstructive pattern. This is in harmony with the findings of Kanat et al [30] who reported that HRCT findings compatible with interstitial lung disease were the commonest encountered findings followed by pulmonary nodules and emphysema. In addition, the study of Karazincir et al [29] listed interstitial lung involvement as the commonest abnormality on HRCT imaging (36%).…”

“…On the other hand, our findings are apparently less than that of some other studies (67.3% [23] and 63% [30]). This is probably attributed to the fact that nearly a quarter of the patients enrolled in these studies were smokers while smokers were primarily excluded from our study.…”

“…Dyspnea was the most frequent symptom consistently with previous reports [43]. Prior studies had reported different prevalence of pulmonary symptoms in RA patients (41, 42, 70%) [12,30,43]. This variation in the results may be explained by the different inclusion and exclusion criteria and different sample size.…”

“…As might be expected, respiratory symptoms were statistically more common in patients with lung disease. Previous studies have reported the association of symptoms with lung disease in RA [13,30], but, however, Dawson et al [11] detected no difference in the prevalence of respiratory symptoms in patients with HRCT documented lung disease compared to patients without.…”