Thoracic manifestations of rheumatic disease: a radiologist's view

With varying prevalence and manifestations depending on the underlying disease, thoracic involvement is one of the major factors determining morbidity and mortality in patients with rheumatic diseases (RDs). The most frequent pulmonary complication is interstitial lung disease (ILD), but other thoracic manifestations can also be present. Often, the only way to depict these extra-articular manifestations of disease is through imaging. Making an early diagnosis and thus aiding in the appropriate management requires radiologists to possess a comprehensive understanding of the typical imaging findings and the accompanying clinical context. In this review, the common features of thoracic involvement in RD are systematically described, with illustrations and explanatory drawings. ILD patterns, rheumatoid nodules, bronchial involvement, esophageal involvement, and pleural and pericardial disease are among the features discussed.