HIGH RESOLUTION COMPUTED TOMOGRAPHY AND PULMONARY FUNCTION TESTS IN EVALUATION OF RHEUMATOID ARTHRITIS PATIENTS WITH AND WITHOUT RESPIRATORY SYMPTOMS
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Pulmonary involvement is a well known extra-articular manifestation of rheumatoid arthritis (RA). So this study was planned to evaluate the role of high resolution computed tomography (HRCT) scanning and pulmonary function tests (PFTs) in detection of pleuro-pulmonary abnormalities in £4 patients with and without respiratory symptoms. This study included 35 non-smokers RA patients, diagnosed according to the criteria of American Rheumatism Association, 12 males their age ranged from 33 to 65 years (mean ISO, 48.95 18.73) and 23 females their age ranged from 25 to 57 years (mean 1SD, 33.8516.31). They were divided into: group I included 20 RA patients with respiratory symptoms and group H included 15 £4 patients without respiratory symptoms. All RA patients were studied through, full detailed medical history and clinical examination, routine laboratory investigations, plain x-ray chest; HRCT scan chest and PFTs (FE171%, FVC%, FEY 1/FVC%, FEF)5.75., and DLCO). Results: Chest x-ray was abnormal in 35% in group I and was normal in all group ll patients. PFTs were abnormal in 45% and 27% in patients of group land group H respectively, HRCT scan was abnormal in 100% and 60% in patients of group I and group ll respectively. The most frequent PFTs abnormality was the restrictive ventilatory pattern and diffusion defect, but 1LD was the most frequent abnormality detected by HRCT scan chest in RA patients. In conclusion, HRCT scan chest was more sensitive than PFTs and conventional x-ray chest in detection of pleuropulmonary abnormalities in RA patients with and without respiratory symptoms.