[Pulmonary manifestations in rheumatoid arthritis: high-resolution computed tomography in correlation with the skeletal changes and the laboratory chemical changes]

Rofo. 1996 Nov;165(5):438-44. doi: 10.1055/s-2007-1015786.
[Article in German]


Purpose: It has been the aim of the following study to evaluate pulmonary changes in rheumatoid arthritis with high-resolution CT and to assess their correlation with joint manifestation and laboratory parameters.

Material and methods: The authors prospectively performed computed tomography (CT) in 83 patients with rheumatoid arthritis and graded pulmonary changes for frequency and severity. Included were patients with 6-7/7 ARA, BSR > 25/1 min and mean disease duration of 12 years (range, 1-44). Data of medical and drug histories, smoking habits, blood levels of rheumatoid factor (RF), antinuclear antibodies (ANA) and C-reactive protein as well as the degree of joint involvement were taken into account.

Results: 58 patients (70%) had pathological CT scans showing the following abnormalities: interlobular thickening (44.5%), intralobular thickening (34%), nonseptal linear attenuation (35%), nodular or linear pleural thickening (32.5%), ground-glass pattern (19%), centrilobular nodules (13%), honeycombing (13%) and bronchiolectasis (9%). Intralobular thickening, honeycombing and pleural thickening were associated with a higher degree of joint manifestation; pleural thickening, honeycombing and ground-glass pattern were associated with a higher level of rheumatoid factor. There was no relationship between pulmonary changes and either the duration of the disease, antinuclear antibodies (ANA) or C-reactive protein.

Conclusion: CT may be a useful noninvasive tool for recognition of RA-associated lung disease. Interstitial lung changes are frequent and they are independent of the duration of the disease. Pulmonary interstitial changes are more frequent and more severe in RF-positive patients and in case of more severe joint involvement.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / complications
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Arthritis, Rheumatoid / pathology
  • Arthrography*
  • Female
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology
  • Lung Diseases / blood
  • Lung Diseases / diagnostic imaging*
  • Lung Diseases / etiology
  • Lung Diseases / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods*
  • Tomography, X-Ray Computed / statistics & numerical data