How do you screen rheumatoid arthritis patients for lung disease (modality, frequency, patient selection)?

This question is part of our collaboration with ACR Convergence 2024 to Continue the Conversation from the meeeting. This question was inspired by the session "Rheumatoid Arthritis-Associated Interstitial Lung Disease: Advances in Screening, Diagnosis and Patient Phenotyping" by Dr. Scott Matson, Dr. Bryant England, and Dr. Vanessa Smith.

Answer from: at Academic Institution

Theoretically, we are supposed to screen these patients obtaining a baseline chest X-ray before starting DMARD therapy. As I remember, these guidelines were formulated when MTX was still blamed for MTX lung disease although presently, even the presence of underlying ILD is not necessarily a contrain...

Comments

at Geisinger Community Medical Center Pulmonary And Sleep Clinic
I will start with a PFT, chest X-ray, and walk tes...

at Uniformed Services University of the Health Sciences (USUHS)
What Dr. @Emilio Gonzalez points out in his next-t...

Answer from: at Academic Institution

RA patients are usually not screened for ILD on initial diagnosis and evaluation. They may be screened if they have underlying risk factors of lung disease (asthma, COPD, or smoking). Once ILD is suspected, they follow ILD evaluation and management protocols.

Comments

at NewYork-Presbyterian Medical Group
I have started screening all new patients with RA ...

Answer from: at Academic Institution

The literature provides some guidance regarding ILD screening for RA. Risk factors are well known; male sex, Hx of smoking, high titer RF/CCP, older age, and disease activity. Given the prevalence of ILD in RA (8-10%) we should be asking about respiratory symptoms during visits with our RA patients....

Answer from: at Academic Institution

I will screen if the patient has symptoms suggestive of lung disease.

Comments

at Mass General Brigham Pentucket Medical
Or if the patient has respiratory symptoms (even u...

Answer from: at Community Practice

I usually screen patients with a chest X-ray and send them for pulmonary function tests (PFTs) if they have a cough or shortness of breath. If they are smokers and have a cough, I try to avoid methotrexate.

Please select the option that best describes you:

How do you screen rheumatoid arthritis patients for lung disease (modality, frequency, patient selection)?

Related Questions