الفهرس 
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Abstract
Summary
Rheumatoid arthritis (RA) is the most commonly encountered connective tissue disease. It is mostly affect synovial tissue with a prevelance ranging from 0.5% to 2%, and the female to male ratio is 2.5:1 most frequently seen in the 25-55 yrs age group. Although the central pathology of RA develops within the synovium of diarthroidal joints, many non-articular organs become involved, particularly in patients with severe joint disease.
Pulmonary involvement is a well known extra-articular manifestation of RA and might be the second cause of death after infection. This pulmonary involvement in RA patients can be assessed as interstitial pneumonitis and fibrosis, pleural involvement, pulmonary nodule, bronchiolitis obliterans organizing pneumonia, arthritis associated with pulmonary hypertension, and involvements of small and large airways.
Pulmonary function tests (PFTs) are an important tool in the investigation and monitoring of patients with respiratory pathology. They provide important information relating to the large and small airways, the pulmonary parenchyma and the size and integrity of the pulmonary capillary bed. Although they do not provide a diagnosis per se, different patterns of abnormalities are seen in various respiratory diseases which helps to establish a diagnosis. Abnormalities detected by PFTs may precede respiratory symptoms by years and lead to early diagnosis of
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pulmonary fibrosis in Rheumatoid arthritis and hence early intervention.
In view of the above, the present study was undertaken to assess the value of PFTs in early detection of pulmonary involvement in patients with Rheumatoid arthritis who have respiratory symptoms and also who are free (asymptomatic).
The study included 40 patients of Rheumatoid arthritis who have met the ACR/EULAR 2010 classification criteria, age 20 to 65 years, then devided in to two groups (20 cases were symptomatic and 20 cases free from respiratory symptoms). All patients underwent PFTs study(spirometry).
The results obtained were collected, tabulated and submitted for statistical analysis.
The following results were obtained :
Among 20 symptomatic patients with RA, 16 cases (80%) had abnormal PFTs, While among the other 20 asymptomatic group only 8 cases (40%) had abnormalities in PFTs.
Rheumatoid arthritis duration (years) was non-significantly higher among symptomatic group in comparison to asymptomatic.
Among symptomatic group, Cough was the most frequent symptom, followed by exertional dyspnea.
Serum RF (IU/mL) was significantly higher among the symptomatic group.
Spirometric results of current study showed that majority of symptomatic group have small airway disease
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obstructive pattern(60%),followed by restrictive pattern(45%) and the least is large airway obstructive pattern (25%). On the other hand, in asymptomatic group majority have predominant normal pattern (60%), followed by small airway disease(25%), then restrictive pattern (10%), and the least is obstructive pattern (5%).
Pulmonary functions measures were lower among symptomatic group; the differences were significant except in FEV1/FVC. Also Pulmonary functions abnormailirites were more frequent among symptomatic group; the differences were significant except in obstructive condition.
There were significant negative correlations between serum RF and FEV1, FVC& MMEF in symptomatic group as well as between serum RF and FEV1& FVC in asymptomatic group.
Regarding diagnostic performance of serum RF, we found that Serum RF ≥37.0 IU/mL had moderate diagnostic characteristics in predicting the presence of chest symptoms in patients with rheumatoid arthritis