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Lung findings on thoracic high-resolution computed tomography in patients with ankylosing spondylitis. Correlations with disease duration, clinical findings and pulmonary function testing

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Abstract

The aim of this study was to identify the spectrum of abnormalities revealed on high-resolution computerized tomography (HRCT) in patients with ankylosing spondylitis (AS), to compare findings with those of plain radiography and pulmonary function testing (PFT), and to look for correlations between lung involvement and AS severity. We prospectively studied 55 consecutive patients with a diagnosis of AS according to the modified New York criteria who attended our department over a period of 2 years. All patients had a detailed rheumatological examination and underwent plain chest radiography, chest HRCT and PFT. HRCT revealed abnormalities in 29 patients (52.7%), whereas plain chest radiography was abnormal in only 2. Abnormalities consisted of interstitial lung disease (ILD) (n=4), apical fibrosis (n=5), emphysema (n=5), bronchiectasis (n=4), ground glass attenuation (n=2), and non-specific interstitial abnormalities (n=26). Only apical fibrosis and bronchiectasis were statistically more frequent with increasing disease duration (significant trend χ2test, p=0.0029 and 0.028, respectively). PFT showed a restrictive process in 19 patients (34.5%). No correlation was noted between HRCT and PFT, nor with AS symptomatic and structural severity parameters. However, there was a statistically significant correlation between PFT and AS symptomatic and structural severity parameters. In conclusion,: this study confirms that the chest HRCT of patients with AS showed a great number of abnormalities undetectable by standard X-rays. The high incidence of lung abnormalities emphasizes the importance of excluding such a diagnosis in patients with AS even without respiratory symptoms.

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Abbreviations

AF:

Apical fibrosis

AS:

Ankylosing spondylitis

FVC:

Forced vital capacity

FEV1 :

Forced expiratory volume in 1 s

HRCT:

High-resolution computerized tomography

ILD:

Interstitial lung disease

PFT:

Pulmonary function tests

VC:

Vital capacity

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Acknowledgments

We thank Professor R. Abouqual and Dr I. Jroundi for statistical help. Supported in part by a grant from Pfizer.

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Correspondence to Abdellah El Maghraoui.

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El Maghraoui, A., Chaouir, S., Abid, A. et al. Lung findings on thoracic high-resolution computed tomography in patients with ankylosing spondylitis. Correlations with disease duration, clinical findings and pulmonary function testing. Clin Rheumatol 23, 123–128 (2004). https://doi.org/10.1007/s10067-003-0845-8

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