USE OF HIGH-RESOLUTION COMPUTED-TOMOGRAPHY OF THE LUNGS IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Objective-To assess the usefulness of high resolution computed tomogra phy (HRCT) of the lungs in patients with rheumatoid arthritis (RA) wit h and without respiratory symptoms. Patients and methods-Eighty eight RA patients with a mean duration of disease 12 (SD 8) years were evalu ated. Eleven patients were excluded because of previous exposure to si lica. The 77 remaining patients formed two groups according to the abs ence (group I, n=38) or the presence (group II, n=39) of chronic respi ratory symptoms. A control group consisted of 51 non-smoking, healthy patients. Results-The most frequent abnormalities observed in the 77 R A patients were bronchiectasis or bronchiolectasis (n=23, 30%), pulmon ary nodules (n=17, 22%), subpleural micronodules or pseudoplaques (n=1 3, 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) tha n in group I (no respiratory symptoms). Non-linear septal opacities we re more frequent in group I than in the control group, but other HRCT findings did not differ statistically significantly between group I an d 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%).