In patients with established rheumatoid arthritis, all of the following pulmonary radiographic findings may be explained by their rheumatologic condition EXCEPT:
1.Bilateral interstitial infiltrates
2.Bronchiectasis
3.Lobar infiltrate
4.Solitary pulmonary nodule
5.Unilateral pleural effusion
sol:
There is potential involvement of multiple organ systems in RA. The most common pulmonary complication is pleural effusion that is typically exudative and presents with chest pain and dyspnea. RA is associated with a form of diffuse interstitial lung disease that may present with dyspnea and bilateral interstitial infiltrates that may be extensive enough to develop into a honeycomb pattern. Pulmonary nodules associated with RA may be solitary or multiple. They often occur in conjunction with cutaneous nodules. Bronchiectasis and respiratory bronchiolitis may also be due to RA. Many of these manifestations respond to immunosuppressive therapy. Lobar infiltrate has not been described due to RA and is more commonly due to an acute infectious etiology, often as a complication of RA immunosuppressive therapy.