Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications

Eur J Radiol. 2015 Oct;84(10):1981-91. doi: 10.1016/j.ejrad.2015.07.008. Epub 2015 Jul 17.

Abstract

Non-cardiac thoracic manifestations of rheumatoid arthritis (RA) cause significant morbidity and mortality among RA patients. Essentially all anatomic compartments in the chest can be affected including the pleura, pulmonary parenchyma, airway, and vasculature. In addition, treatment-related complications and opportunistic infections are not uncommon. Accurate diagnosis of intra-thoracic disease in an RA patient can be difficult as the radiologic findings may be nonspecific and many of these conditions may coexist. This review article serves to highlight the multitude of RA-related intra-thoracic pathological processes, emphasize differential diagnosis, diagnostic conundrums and discuss how tailoring of CT imaging and image-guided biopsy plays a key role in the management of RA-related pulmonary disease.

Keywords: Drug toxicity; Interstitial lung disease; Pleural disease; Rheumatoid arthritis; Rheumatoid nodule.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / adverse effects
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Diagnosis, Differential
  • Humans
  • Image-Guided Biopsy / methods
  • Lung Diseases / diagnosis
  • Lung Diseases / etiology*
  • Opportunistic Infections / etiology
  • Pleural Diseases / diagnosis
  • Pleural Diseases / etiology*
  • Tomography, X-Ray Computed / methods

Substances

  • Antirheumatic Agents