Radiological Evaluation of Lung Findings in Rheumatoid Arthritis Patients According to Time of Diagnosis

Abstract

Background:Rheumatoid arthritis (RA) is a systemic autoimmune disease that frequently involves the lungs, leading to morbidity and mortality. Pulmonary manifestations include interstitial lung disease, rheumatoid nodules, bronchiectasis, and pleural effusion. Although posteroanterior chest radiography (PA-CR) is widely used as the initial imaging method, computed tomography (CT) offers higher sensitivity for detecting these abnormalities.
Purpose:To evaluate PA-CR and CT findings of common RA-related lung pathologies according to disease follow-up duration and to guide selection of the appropriate modality.
Material and Methods:109 patients diagnosed with RA who underwent both PA-CR and thoracic CT were included. Demographic data (age, sex) and follow-up durations were recorded. Patients were divided into three groups (≤5 years, 5–10 years, and ≥10 years). PA-CR and CT findings were compared within and between groups and statistically analyzed.
Results:Lung findings were detected in 75 patients (68.8%). Among those with lung involvement, 64.9% were female and 35.1% were male (p=0.027). Patients with involvement were older (61.3 ± 9.2 vs 55.6 ± 13.0 years, p=0.010). A significant association was found between nodules on PA-CR and follow-up duration (p=0.033). In patients followed for ≥10 years, interstitial lung disease, pulmonary nodules, and bronchiectasis were significantly more frequent on CT than on PA-CR (p=0.044, p=0.001, and p=0.001, respectively).
Conclusion:For RA patients with less than 10 years of follow-up, PA-CR may be preferred as the initial imaging modality. In those followed for 10 years or longer, CT is recommended as the primary modality due to its superior sensitivity in detecting RA-related lung abnormalities.