Abstract
To determine the prevalence of lung involvement and the spectrum of abnormalities revealed on HRCT in patients with AS, a systematic literature review was conducted in the Medline database up to May 2009 and in the abstracts of rheumatology scientific meetings (2006–2008). A hand search of references was also performed. Among the 264 selected articles, 10 articles (303 patients) allowed a calculation of the prevalence of lung abnormalities on thoracic HRCT in AS. A total of 185 patients (61%) had an abnormal thoracic HRCT: upper lobe fibrosis in 21 (6.9%), emphysema in 55 (18.1%), bronchiectasis in 33 (10.8%), and ground glass attenuation in 34 (11.2%). Non specific interstitial abnormalities were observed in 101 (33%) patients. The most common observed abnormalities were pleural thickening (52%), parenchymal bands (45%) and interlobular septal thickening (30%). Only the prevalence of upper lobe fibrosis increased significantly with disease duration (3 studies). Mild and non-specific interstitial abnormalities on thoracic HRCT are common in patients with AS, even in patients with early disease and without respiratory symptoms.
Highlights
Ankylosing spondylitis (AS) is a chronic rheumatic disorder characterized by inflammation of the enthesis and sometimes the joints, which may lead to ankylosis [1]
The advent of high resolution computed tomography (HRCT) in the mid 1980s has allowed physicians to examine the entire lung parenchyma and pleura in many conditions with diffuse lung disease using a noninvasive method [13]. The objective of this analysis was to determine the prevalence of lung involvement and the spectrum of abnormalities revealed on HRCT in patients with AS according to the disease duration and to describe its clinical characteristics by a systematic literature review
With or without cavitation, was a rare HRCT finding reported in 6.9%
Summary
Ankylosing spondylitis (AS) is a chronic rheumatic disorder characterized by inflammation of the enthesis (especially of the axial skeleton) and sometimes the joints, which may lead to ankylosis [1]. Lung involvement is a wellrecognized extra-articular feature of AS It was initially described in 1941 [5]. The advent of high resolution computed tomography (HRCT) in the mid 1980s has allowed physicians to examine the entire lung parenchyma and pleura in many conditions with diffuse lung disease using a noninvasive method [13]. The objective of this analysis was to determine the prevalence of lung involvement and the spectrum of abnormalities revealed on HRCT in patients with AS according to the disease duration and to describe its clinical characteristics by a systematic literature review
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