Imaging aspects of interstitial lung disease in patients with rheumatoid arthritis: Literature review

Autoimmun Rev. 2018 Feb;17(2):87-93. doi: 10.1016/j.autrev.2017.09.013. Epub 2017 Nov 28.

Abstract

Objective: Interstitial lung disease (ILD) is a frequent and severe complication of rheumatoid arthritis (RA), resulting in pulmonary fibrosis (PF) and respiratory failure.

Methods: Chest computed tomography (CT-c) or high resolution CT (HRCT) is the main modality for assessment of ILD. We performed a systematic literature review on CT-c/HRCT findings in patients with ILD-RA, using the MEDLINE database for the period from 1991 to 2015.

Results: Findings on CT-c/HRCT attributed to ILD-RA are variable (ground glass opacities, reticular and nodular pattern, as well as a combined pattern of emphysema and PF). Correlation of CT-c/HRCT findings with clinical data is inconsistent.

Conclusions: ILD-RA is part of a general autoimmune inflammation and should be integrated into the decision-making process for the treatment of RA. There is an unmet need to design an algorithm which will allow prediction of CT-c changes compatible with ILD-RA with a high probability. Hopefully, this will enable treating patients with ILD-RA early, with possible halting of the progression of ILD-RA toward PF.

Keywords: Chest computed tomography; High resolution computed tomography; Interstitial lung disease; Rheumatoid arthritis; Rheumatoid lung.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Arthritis, Rheumatoid / complications*
  • Disease Progression
  • Female
  • Humans
  • Lung Diseases, Interstitial / diagnostic imaging*
  • Lung Diseases, Interstitial / etiology
  • Lung Diseases, Interstitial / pathology
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed / methods*