Rheumatoid arthritis pulmonary nodules

Since the first descriptions of the rapid development of a large number of nodules, also termed accelerated nodu-losis, in methotrexate-treated patients, a number of such reports have accumulated in patients with rheumatoid arthritis or, more rarely, psoriatic arthritis (66-68). Nodulosis is characterized by the development of small, painful, multiple nodules, sometimes disseminated pulmonary, meningeal, or pericardial nodulosis has also been... 

Rheumatoid arthritis may involve the pleura of the lung, which is often asymptomatic, although pleural effusions may result. Pulmonary fibrosis also may develop as a result of rheumatoid involvement smoking appears to increase the risk of this complication. Rheumatoid nodules may develop in lung tissue and appear similar to neoplasms on chest x-ray films. Interstitial pneumonitis and arteritis are rare, potentially life-threatening complications of rheumatoid arthritis. 

Figure 1 Chest computed tomography demonstrating multiple pulmonary nodules from rheumatoid arthritis. Note that nodules are of different sizes and may he scattered randomly throughout the lung parenchyma. Cavitation can occur as seen in the largest nodule on this cut from chest computed tomography.

Hubscher O, Re R, lotti R. Pulmonary rheumatoid nodules in an etanercept-treated patient. Arthritis Rheum 2003 48(7) 2077-8. 

---