Learning objectives
The goal of our work is depict in an organized fashion the pulmonary HRCT findings that can be encountered in RA.
Background
Rheumatoid arthritis (RA) is a systemic inflammatory disease that affects approximately 1% of the population.
Pleuropulmonary complications are frequent and responsible for a significant part of mortality associated with this disease.
Moreover,
despite the prevalence of other extra-articular manifestations is declining,
RA-associated lung disease is increasing.
Another interesting fact is that the lung involvement in RA is seen more commonly in men than women.
Pleuropulmonary manifestations of RA are varied,
including RA-associated interstitial lung disease (ILD),
pleural effusions,
rheumatoid nodules,
and airway involvement.
High-resolution computed...
Findings and procedure details
Pleural disease:
Pleural disease is one of the most frequent thoracic complications of RA.
It can affect in up to 50% of patients and englobes pleural effusions,
pleural thickening,
empyema and pneumothorax.
-Pleural effusions and pleural thickening:
Pleural effusion is a common finding in patients with a long-standing RA,
middle-aged men with high rheumatoid factor titer and rheumatoid nodules.
It isusually small to moderate in size and unilateral (Fig. 1),
may be loculated.
Unresolved effusions may lead to marked pleural thickening,
causing a trapped lung...
Conclusion
Taking into account the prevalence of RA and the frequency of pulmonary complications,
radiologists should be familiar with HRCT findings associated with this disease.
Moreover,
the pulmonary changes can help in the diagnosis of this disease,
as well as being important in therapeutic management.
Personal information
Márcio Rodrigues,
M.D.
Department of Radiology,
Centro Hospitalar de São João,
Porto,
Portugal
[email protected]
References
Tanoue,
L.
Pulmonary manifestations of rheumatoid arthritis.
Clinics in chest medicine 19.4 (1998): 667-685.
Tanaka,
N et al.
Rheumatoid Arthritis–related Lung Diseases: CT Findings 1.
Radiology 232.1 (2004): 81-91.
Amital,
A et al.
The lung in rheumatoid arthritis.
La Presse Médicale 40.1 (2011): 53-70.
Manjunatha,
Y et al.
Rheumatoid arthritis: spectrum of computed tomographic findings in pulmonary diseases.
Current problems in diagnostic radiology 39.6 (2010): 235-246.
Ruano,
C et al.
Thoracic Manifestations of Connective Tissue Diseases.
Current problems in diagnostic radiology 44.1 (2015): 47-59.
Perez,...
