How do you approach dyspnea in a seropositive rheumatoid arthritis patient with normal imaging findings but abnormal PFT findings (restriction, reduced DLCO)?  

Pulmonary pathophysiological abnormalities are common in individuals with rheumatoid arthritis (RA) and respiratory symptoms. In individuals without respiratory symptoms, abnormalities may even be detected by lung function testing or high-resolution CT imaging. Any compartment of the lungs may be in...

I first do a careful history and physical. Does the patient have significant arthropathy or features of other CTDs? Sometimes, RA (and scleroderma) can reduce lung volumes due to the effects of arthropathy or tissue stiffening, respectively. Any drugs such as DMARDs that could induce a pneumonitis (...