Why You Need a Chest Scan-Lung diseases often accompany connective tissue disorders

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Why You Need a Chest Scan-Lung diseases often accompany connective tissue disorders

Arthritis Today
By Denise Lynn Mann


If you have a connective tissue disorder, add this to your to-do list: Talk to your doctor about getting a baseline chest X-ray, if you have not had one.

Interstitial lung disease can affect people with rheumatoid arthritis (RA) or scleroderma, damaging lung tissue, inflaming the walls of the air sacs in the lung, scarring tissue between the air sacs and stiffening the lung, says Kevin K. Brown, MD, vice chair of medicine and head of the Interstitial Lung Disease Program at the National Jewish Medical and Research Center in Denver.

Dr. Brown says that if every patient with scleroderma or RA had a chest scan, probably more than half would show interstitial lung disease, but the severity varies widely.

“Many patients may not even know there is anything wrong with their lungs,” says Dr. Brown. They may show evidence of disease on a scan, but be physically active and have no symptoms whatsoever, he says. Others, though, may have such severe arthritis that they are not physically active enough to know if they have breathing problems.

“X-ray evidence does not mean the disease will progress or ultimately cause great harm,” he says. Still, a baseline evaluation is a good idea for people with connective tissue diseases, he says, because if symptoms develop in the future, doctors will have a good idea about what’s going on. When changes are seen on X-ray, doctors may do a lung function test to see if other problems are identified. “If they are, we would pay much closer attention to the lungs, but if other signs are normal, we are much less worried,” he says.

“We are more optimistic than we have been in the past, but people with connective tissue diseases remain among the most challenging to treat,” says David Badesch, MD, a professor of medicine in the division of pulmonary science and critical care medicine at the University of Colorado Health Sciences Center in Denver. “These patients should be co-managed by a rheumatologist and a pulmonologist or cardiologist because such combined care can allow doctors to address lung problems from all angles, resulting in better care and greater improvements in health,” he says.

(Arthritis Today, Jan-Feb 2007)