THE ROLE OF CLINICAL ASSESSMENT, PULMONARY FUNCTION TESTS AND HIGH RESOLUTION COMPUTED TOMOGRAPHY IN EVALUATION OF PULMONARY INVOLVEMENT IN RHEUMATOID ARTHRITIS PATIENTS

INTRODUCTION: Rheumatoid arthritis is a common systemic disease that manifests as inflammatory arthritis of multiple joints and produces a wide variety of intrathoracic lesions, including pleural diseases, rheumatoid nodules, diffuse interstitial pneumonia, pulmonary vasculitis, and airway disease that includes bronchiectasis, bronchiolitis obliterans, and follicular bronchiolitis. Early recognition of lung involvement is of considerable significance as frequently unrecognised pulmonary involvement ends up as fibrosis with irreversible deficits in respiratory function.AIM OF THE WORK: The aim of this work is to evaluate the pulmonary affection in patients with rheumatoid arthritis by clinical assessment, pulmonary function tests and high resolution computed tomography.PATIENTS AND METHODS: Forty rheumatoid arthritis patients were included in the study, allwere subjected to history taking, general examination, chest examination, joint examination, laboratory investigations, chest X-ray, PFT and HRCT. They were divided into group 1 under methotrexate and group 2 who never received methotrexate.RESULTS: There were high significant relations between overall findings of PFT and HRCT. Relations between chest symptoms and PFT were highly significant as well. We found no significant difference between group (1) on methotrexate therapy and group (2) regarding results in X-ray, symptoms , PFT and HRCT.CONCLUSION: pulmonary involvement in RA is common and can be due to the disease itself as well as to the therapies like methotrexate which is an additional risk factor, also we concluded that the common plmonary manifestation is the interstitial fibrosis. HRCT proved sensitive in detecting abnormalities that were clinically silent and missed by plain radiography. HRCT accurately illustrates the pathology of lungs. Pulmonary function tests accurately illustrate the physiology of lung function so correlations between HRCT abnormalities and PFT may complement one another.