Abstract
Background and aimRheumatoid arthritis (RA) is a chronic inflammatory systemic disease characterized by bilateral involvement of mostly small joints of hands and feet. There can be various extra-articular manifestations of the disease including lung parenchymal disease. Pulmonary involvement in RA patients leads to increased morbidity and mortality. The overall burden of RA related pulmonary disease is underestimated due to the limitation of resources in underdeveloped countries. High-resolution computed tomography (HRCT) is an important tool used to diagnose different abnormalities in RA related interstitial lung disease (ILD). The objective of the study was to evaluate HRCT findings in patients of RA related ILD and categorize the radiological findings according to clinical findings.MethodThis descriptive prospective observational study was conducted at Mayo Hospital, Lahore from June 2014 to June 2015. Patients of RA suspected of lung disease after selection underwent HRCT chest on 128-slice Hitachi CT scanner (Hitachi Global, Tokyo, Japan) in the radiology department. Images were reconstructed and evaluated by experienced radiologists. Findings were recorded on a questionnaire. Data was analyzed on SPSS version 21 (IBM Corp, Armonk, US).ResultsOut of the 54 patients scanned, interlobular septal thickening was the most common finding found in 22 of the patients. Ground-glass opacification was recognized in 21 patients, honeycombing in nine and bronchiectasis in two patients. Regarding zonal predilection of disease pattern, lower zones of lungs were found involved in most of the cases. The disease was found to be bilateral in 15 patients. Based on these findings, usual interstitial pneumonitis (UIP) was diagnosed in six patients and non-specific interstitial pneumonitis (NSIP) in 14 others.ConclusionThis study concluded that HRCT images are very useful in diagnosing interstitial lung disease related to rheumatoid arthritis.
Highlights
Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease exhibiting clinical signs and symptoms of predominantly joint disease [1,2,3]
Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease characterized by bilateral involvement of mostly small joints of hands and feet
Ground-glass opacification was recognized in 21 patients, honeycombing in nine and bronchiectasis in two patients
Summary
Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease exhibiting clinical signs and symptoms of predominantly joint disease [1,2,3]. This disease is characterized by symmetrical bilateral involvement of mostly small joints of hand and feet; as it leads to chronic synovitis, all joints may be involved [4,5]. Pulmonary involvement seen in RA patients has high clinical significance as it leads to increased morbidity and mortality [11]. Rheumatoid arthritis (RA) is a chronic inflammatory systemic disease characterized by bilateral involvement of mostly small joints of hands and feet. The objective of the study was to evaluate HRCT findings in patients of RA related ILD and categorize the radiological findings according to clinical findings
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