Rheumatoid lung disease is a group of lung problems related to rheumatoid arthritis. The condition can include fluid in the chest (pleural effusions), scarring (pulmonary fibrosis), lumps (nodules), and high blood pressure in the lungs (pulmonary hypertension).

Pulmonary abnormalities are common in rheumatoid arthritis, but they often cause no symptoms. The causes of lung disease associated with rheumatoid arthritis are unknown. Sometimes the medicines used to treat rheumatoid arthritis may result in lung disease.

• Shortness of breath
• Cough
• Chest pain
• Fever

• Joint swelling
• Joint stiffness
• Joint pain
• Skin nodules

The doctor may hear crackles when listening to the lungs with a stethoscope (auscultation). Or, the patient may have decreased breath sounds, a rubbing sound, or normal breath sounds.

The following tests may show problems consistent with rheumatoid lung disease:

• Chest x-ray
• CT scan of the chest
• Echocardiogram (may show pulmonary hypertension)
• Needle inserted into the fluid around the lung (thoracentesis)
• Bronchoscopic, video-assisted, or open lung biopsy

Many people with this condition have no symptoms. Therefore, therapies are aimed at treating the underlying disorder and complications resulting from the disorder. Corticosteroids or other immunosuppressive therapies are sometimes useful.

The outcome is related to the underlying disorder and the type and severity of lung disease.

• Pneumothorax
• Pulmonary hypertension

Call your health care provider PROMPTLY if you have rheumatoid arthritis and you develop unexplained breathing difficulties.

Strange C, Highland KB. Interstitial lung disease in the patient who has connective tissue disease. Clin Chest Med. September 2004;25:549-559.

Zrour SH, Touzi M, Bejia I, et al. Correlations between high-resolution computed tomography of the chest and clinical function in patients with rheumatoid arthritis. Prospective study in 75 patients. Joint Bone Spine. January 2005;72:41-47.