From the Journal of Rheumatology....
SHUNSUKE MORI, ISAMU CHO, YUKINORI KOGA, and MINEHARU SUGIMOTO
ABSTRACT.
Objective. To identify the predominant radiological abnormalities in the lungs of patients with early rheumatoid arthritis (RA) and in those with longstanding RA.
Methods. We performed high-resolution computed tomography (HRCT) on a total of 126 patients with early RA (n = 65) and longstanding RA (n = 61). The most likely diagnosis for each case was made on the basis of the predominant HRCT findings and their extent in the lungs. Pulmonary function tests were done for RA patients with parenchymal abnormalities.
Results. The most frequent finding was bronchial dilatation (41.3%), followed by ground-glass attenuation (27.0%), parenchymal micronodules (15.1%), subpleural micronodules (15.1%), reticulation (11.9%), bronchial wall thickening (11.9%), nodules (10.3%), honeycombing (8.7%), and airspace consolidation (4%). Parenchymal micronodules and bronchial wall thickening, indicative of small airway diseases, were more prominent in the patients with longstanding RA. There were no significant differences in the frequency of interstitial abnormalities such as ground-glass attenuation, reticulation, honeycombing, or consolidation between the 2 groups. We identified 10 patients with bronchiolitis pattern, 11 with nonspecific interstitial pneumonia (NSIP) pattern, 2 with usual interstitial pneumonia (UIP) pattern, and 2 with organizing pneumonia (OP) pattern. Mean values of FEV1/FVC ratio and FEV25-75 were lower in the patients with the bronchiolitis pattern, and DLCO was decreased in the patients with the NSIP or UIP pattern.
Conclusion. Interstitial abnormalities were frequently observed even in patients with early RA, although most of them had no respiratory symptoms. Bronchiolar abnormalities were associated with the duration of RA. (First Release June 15 2008; J Rheumatol 2008;35:1513–21)
Besides having a yearly cardiac workup it's essential to have a yearly chest xray. Sometimes our doctors get so caught up in the RA side of our health they forget to look at the possible complications of RA and don't order yearly testing to track your overall health. My pulmonary complications showed up early, in fact right after I was diagnosed with RA I was diagnosed with interstitial lung disease. I had pneumonia 3 times in 2 years. I haven't had pneumonia in the last 8 years but I still show ILD on my chest xrays. If you haven't had a baseline chest xray ask your RD about it. Lindy Thanks Lynn and LinB, interesting study and good advice! You're welcome waddie