Bronchiolitis obliterans associated with rheumatoid arthritis: findings on HRCT and dynamic expiratory CT.

OBJECTIVE

To show the CT findings of bronchiolitis obliterans (BO) associated with rheumatoid arthritis.

MATERIALS AND METHODS

We used high-resolution CT (HRCT) and dynamic expiratory cine CT to evaluate two patients with rheumatoid arthritis and a clinical diagnosis of BO. Both had pulmonary function tests to correlate with the radiographic findings.

RESULTS

High-resolution CT showed bronchiectasis and mosaic perfusion in both patients. Expiratory CT showed multiple scattered areas of air trapping consistent with small airway obstruction. Imaging findings correlated with pulmonary function tests, which showed severe airway obstruction and inhomogeneous lung ventilation.

CONCLUSION

Pulmonary HRCT and dynamic expiratory CT are useful in verifying the clinical diagnosis of BO in patients with rheumatoid arthritis, particularly those too unstable to undergo open lung biopsy.