ABSTRACT
Pulmonary involvement is one of the most common extra-articular manifestations of rheumatoid arthritis [RA]. The aim of this prospective study was to evaluate pulmonary involvement in RA patient with assessment of clinical, pulmonary function tests [PFTs], and high resolution computed tomography [HRCT] findings. The study was carried on 60 unselected RA patients; 13 male and 47 female with a mean age 42.8 +/- 9.1 years, the main duration of RA was 8.5 +/- 3.1 years. All cases were diagnosed as having RA, clinical assessment, PFT and HRCT were applied for all RA patients. There were 14 smokers [23.3%], 5 ex-smokers [8.3%] and 41 non-smoker [68.4%]. Thirty two RA patients had respiratory symptoms [53.3%] while 28 had no respiratory symptoms [46.7%]. Twenty nine cases with abnormal X-ray findings [48.3%] and 31 cases [51.7%] with normal X-ray. PFTs were abnormal in 33 [55%] and obstructive pattern was the most frequent 23 [38.3%] with prevalence of small airways obstruction was 16 [26.7%]. HRCT findings were abnormal in 44 RA patients [73.3%]. The most frequent HRCT findings were; bronchiactasis 21 [35%]; air traping 17 [28.3%] and pulmonary nodules 15 [25%]. HRCT and PFTs showed abnormal finding in cases without respiratory symptoms and normal X-ray. There was a high prevalence of small airways involvement and bronchiactasis and air traping it is concluded that there is a high prevalence of airways abnormalities as assessed by HRCT and PFTs in RA patient. The high prevalence of bronchiacetas is on HRCT is associated with high prevalence of small airways involvement