Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications

Highlights • A variety of thoracic processes can be seen in rheumatoid arthritis patients, including interstitial lung disease, drug reaction and toxicity, as well as superimposed infection related to immunosuppression. Accurate diagnosis requires understanding of the typical thoracic manifestations as well as possible infectious, drug-related and surgical complications. • Combination of underlying parenchymal changes and treatment-related immunosuppression predispose rheumatoid arthritis patients to opportunistic and severe infection. • Several thoracic conditions in rheumatoid arthritis such as nodular pleural thickening and rheumatoid nodulosis may mimic malignancy or infectious process. Image-guided core needle biopsy is often required to establish the diagnosis. • Several interstitial lung disease patterns may be seen in rheumatoid arthritis, with usual interstitial pneumonia (UIP) being the most common.