Thoracic Manifestations of Rheumatoid Arthritis

Clin Chest Med. 2019 Sep;40(3):545-560. doi: 10.1016/j.ccm.2019.05.003. Epub 2019 Jul 6.

Abstract

Rheumatoid arthritis (RA) is commonly associated with pulmonary disease that can affect any anatomic compartment of the thorax. The most common intrathoracic manifestations of RA include interstitial lung disease, airway disease, pleural disease, rheumatoid nodules, and drug-induced toxicity. Patients with RA with thoracic involvement often present with nonspecific respiratory symptoms, although many are asymptomatic. Therefore, clinicians should routinely consider pulmonary disease when evaluating any patient with RA, particularly one with known risk factors. The optimal screening, diagnostic, and treatment strategies for RA-associated pulmonary disease remain uncertain and are the focus of ongoing investigation.

Keywords: Bronchiectasis; Bronchiolitis; Drug-induced lung toxicity; Rheumatoid arthritis; Rheumatoid arthritis–associated interstitial lung disease; Rheumatoid nodule.

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / pathology
  • Female
  • Humans
  • Lung Diseases, Interstitial / etiology*
  • Lung Diseases, Interstitial / pathology
  • Male
  • Risk Factors