Use of high resolution computed tomography of the lungs in patients with rheumatoid arthritis.

B Cortet, R M Flipo, M Rémy-Jardin, P Coquerelle, B Duquesnoy, J Rêmy, B Delcambre

Department of Rheumatology, CHRU Lille, Hôpital B, France.

OBJECTIVE--To assess the usefulness of high resolution computed tomography (HRCT) of the lungs in patients with rheumatoid arthritis (RA) with and without respiratory symptoms. PATIENTS AND METHODS--Eighty eight RA patients with a mean duration of disease 12 (SD 8) years were evaluated. Eleven patients were excluded because of previous exposure to silica. The 77 remaining patients formed two groups according to the absence (group I, n = 38) or the presence (group II, n = 39) of chronic respiratory symptoms. A control group consisted of 51 non-smoking, healthy patients. RESULTS--The most frequent abnormalities observed in the 77 RA patients were bronchiectasis or bronchiolectasis (n = 23, 30%), pulmonary nodules (n = 17, 22%), subpleural micronodules or pseudoplaques (n = 13, 17%), ground glass opacities (n = 11, 14%), and honeycombing (n = 8, 10%). Bronchiectasis or bronchiolectasis (p = 0.012), rounded opacities (p = 0.016), ground glass attenuation (p = 0.004), and honeycombing (p = 0.002) were found more often in RA group II (with respiratory symptoms) than in group I (no respiratory symptoms). Non-linear septal opacities were more frequent in group I than in the control group, but other HRCT findings did not differ statistically significantly between group I and the control group. CONCLUSION--Bronchiectasis may be a characteristic lung change in RA patients. Abnormalities on HRCT are less frequently observed in the absence of respiratory symptoms than in the presence of such symptoms (29% versus 69%).

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Patel, R., Naik, S., Amchentsev, A., Saleh, A. (2009). A Rare Cause of Multiple Cavitary Nodules. Chest 136: 306-309 [Full Text]  
• Antoniou, K. M., Margaritopoulos, G., Economidou, F., Siafakas, N. M. (2009). Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement. Eur Respir J 33: 882-896 [Abstract] [Full Text]  
• du Bois, R., King, T. E Jr (2007). Challenges in pulmonary fibrosis {middle dot} 5: The NSIP/UIP debate. Thorax 62: 1008-1012 [Abstract] [Full Text]  
• Reuss-Borst, M A, Hartmann, U (2006). Pulmonary nodules as initial manifestation of primary Sjogren's syndrome.. Ann Rheum Dis 65: 685-687 [Full Text]  
• Kaushik, V V, Hutchinson, D, Desmond, J, Lynch, M P, Dawson, J K (2004). Association between bronchiectasis and smoking in patients with rheumatoid arthritis. Ann Rheum Dis 63: 1001-1002 [Full Text]  
• Barker, A. F. (2002). Bronchiectasis. NEJM 346: 1383-1393 [Full Text]  
• White, D. A., Mark, E. J. (2001). Case 10-2001- A 53-Year-Old Woman with Arthritis and Pulmonary Nodules. NEJM 344: 997-1004 [Full Text]  
• TOUSSIROT, E, DESPAUX, J, WENDLING, D (2000). Increased frequency of HLA-DRB1*0401 in patients with RA and bronchiectasis. Ann Rheum Dis 59: 1001b-1001 [Full Text]  
• Cohen, M., Sahn, S. A. (1999). Bronchiectasis in Systemic Diseases. Chest 116: 1063-1074 [Full Text]  
• Cortet, B., Perez, T., Roux, N., Flipo, R.-M., Duquesnoy, B., Delcambre, B., Rémy-Jardin, M. (1997). Pulmonary function tests and high resolution computed tomography of the lungs in patients with rheumatoid arthritis. Ann Rheum Dis 56: 596-600 [Abstract] [Full Text]