Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a progressive chronic systemic autoimmune disorder characterized by symmetric deforming erosive synovitis. Pulmonary involvement may occur in 18% of all patients with RA, is one of the most common extra-articular manifestations of the disease and is a major cause of morbidity and mortality. The most common pleuropulmonary manifestations of RA are rheumatoid-associated interstitial lung disease (RA-ILD), drug related lung disease, infection secondary to immunosuppression, necrobiotic nodules, organizing pneumonia, upper and lower airway disease, pulmonary vascular disease and serositis. A normal chest radiograph does not exclude RA-ILD. As disease progresses, radiographic abnormalities may become more apparent. Thin-section or high resolution computed tomography (HRCT) remains the study of choice to assess RA-ILD. Patients with RA-ILD have a slightly increased incidence of lung cancer, and radiologists must carefully scrutinize images looking for discrete nodules and masses.