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Year : 2006  |  Volume : 16  |  Issue : 4  |  Page : 835-839
"Interstitial Lung disease (Ild) in Rheumatoid arthritis (Ra)"- a study of thirty cases


Department of Radiodiagnosis,V S HOSPITAL, Ellisbridge , Ahmedabad- 380016, India

Correspondence Address:
S Raniga
15, Amrakunj Society,B/h Nehrunagar, S. M. Road,Ambawadi, Ahmedabad-380015
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-3026.32362

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Objectives- The objective of this study is to evaluate the Interstitial Lung Disease (ILD) in the patients with Rheumatoid Arthritis (RA) and to correlate clinico - spirometric profile and High Resolution Computed Tomography (HRCT) findings with regards to early detection of possible lung involvement in the study group. Materials and Methods The present study was carried out at Shree Sayajirao General Hospital (SSGH), Baroda from January 2002 to December 2002. The patients satisfying the American College of Rheumatology (ACR) criteria [1] for RA were included in this study, without regards to the presence of pulmonary symptoms or chest x-ray changes. None of our patient was on Disease Modifying Anti-Rheumatic Drugs (DMARD) therapy. All thirty patients (seven males and twenty three females) - underwent clinical, spirometric, laboratory, x-ray chest and HRCT evaluation of lung. Diagnosis of ILD was confirmed by HRCT and supported by clinical and physiological findings in all patients. All the gathered information and investigations were subjected to statistical analysis. Results Majority of the patients had duration of illness between one and three years. The mean duration of illness was 2.9 years. RA factor was positive in 25 patients (83.3%). Six of the thirty patients had respiratory complaints (20%). Spirometric evidence of lung involvement was present in eight patients (26.6%). Only four of them had abnormalities detectable on chest radiograph (13.33%). HRCT was abnormal in eleven patients (36%). Conclusion In concluding the results of our study, the interstitial lung changes affects significant proportion (36%) of the patients affected with RA. Overall, HRCT is the most sensitive parameter to detect the early interstitial changes in patients with RA. HRCT can show evidence of interstitial lung changes even when clinical and pulmonary function tests parameters are normal. HRCT is superior to plain chest radiograph in the evaluation of early interstitial lung changes associated with RA. Coexisting subcutaneous rheumatoid nodules is a high-risk factor for development of ILD in patients with RA.


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