The “rheumatic lung” in computed tomography: radiological manifestations of rheumatoid arthritis

Thoracic non-cardiac manifestations of rheumatoid arthritis (RA) pose a diagnostic challenge. In addition to a well-functioning interdisciplinary collaboration a profound knowledge of the different manifestations and their radiological correlates is required. Intrapulmonary vessels, lung parenchyma and pleura can be affected in addition to the respiratory tract including the small airways. Interstitial lung disease with a usual interstitial pneumonia (UIP) pattern is a frequent pulmonary manifestation. Therefore, high-resolution computed tomography is the method of choice for diagnostic imaging of pulmonary manifestations of RA. The presence of potential drug-induced toxic parenchymal lesions superimposing pre-existing pulmonary findings represents a further diagnostic challenge and may complicate the image interpretation. Opportunistic infections, induced by immunosuppressive medications, can further complicate the identification and diagnosis of thoracic RA manifestation. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.