Presentation
Known rheumatoid arthritis on treatment for approximately 15 years. A recent CXR demonstrated bilateral increased interstitial markings in the basal lung regions. Noncontrast chest CT requested to evaluate possible RA-associated interstitial lung disease.
Patient Data
![](https://prod-images-static.radiopaedia.org/images/51685362/131f7793a9a65660f622dbe655c1a7_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/51685767/97d243fce3c06bd1020323c2ee3cd6_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/51685768/023fd78cf8965be6b18b2a1a3e9194_thumb.jpeg)
![](https://prod-images-static.radiopaedia.org/images/51685362/131f7793a9a65660f622dbe655c1a7_big_gallery.jpeg)
CT demonstrates a primarily peripheral, subpleural pulmonary fibrosis, which particularly affects the basal segments of the lower lobes (see representative sagittal plane images). Associated honeycombing and bronchiectasis can also be observed.
![](https://prod-images-static.radiopaedia.org/images/51685769/908f1a99e4142fe395bbd0bee2a6ff_big_gallery.jpeg)
Magnified key image demonstrating bronchiectasis, subpleural reticulation and honeycombing.
Case Discussion
Altogether the findings show a distinct UIP pattern, and considering the history are in line with RA-associated ILD.