Pulmonary Involvement of Rheumatoid Arthritis with Special Reference to HRCT Thorax and Spirometry

Objective: This study tries to evaluate the extent of pulmonary involvement of Rheumatoid Arthritis (RA) with the help of High- Resolution Computerized Tomography of Thorax and Spirometer. Thus, this study gives insight about necessity of ruling out pulmonary involvement in patients of Rheumatoid Arthritis early in the phase of treatment to cut-down both morbidity and mortality of such patients by offering them requisite treatment as early intervention.

Methods: The study was conducted in the department of Medicine; Gauhati Medical College & Hospital over 40 cases of RA were diagnosed by the revised criteria for classification of Rheumatoid Arthritis (ACRULAR- 2010 Criteria). The cases were thoroughly studied using a proforma to collect socio-demographic and clinical data. The clinical data collected on the ACR guidelines and laboratory parameter evaluation was also carried out. X-ray of any other joint involved, chest x-ray, ECG, High Resolution Computer Tomography (HRCT) Thorax and spirometer were collected.

Result: More than half (n=21, 52.5%) of the sample had different abnormal lung parenchymal changes on HRCT and half of the sample had abnormal restrictive and mixed pattern in spirometer (n=20, 50%), showing very high prevalence of pulmonary involvement in patients of RA.

Conclusion: There is definite relationship of pulmonary involvement in cases of RA, wherein HRCT proves to be more sensitive in detecting abnormalities that were clinically silent and missed on plain radiography. Good correlation between HRCT and spirometer exists and this contributes to detection of early parenchymal changes.