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Rheumatoid arthritis, chest X-ray showed enlarged lymph node, accentuated hilar and broncho-vascular markings. What does this imply?

Hi, I am 75 years old and I have rheumatoid arthritis . I have just had an x-ray of the chest which revealed: - a well defined sharply marginated soft tissue radiopaque shadow is seen at the right hilar region may suggest enlarged lymph node. - mild accentuated hilar and bronchovascular markings. - clear both lung fields and costo-phrenic angles. - prominent aortic knuckle with dilated unfolded aorta. - normal cardio-thoracic ratio any explanation of the above would be much helpful. thanks in advance
Asked On : Mon, 15 Oct 2012
Answers:  2 Views:  1066
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM
Rheumatoid arthritis is aconnective tissue disorder which primarily affects the joints. Lungs are also involved.
The lung lesions include pleural effusion, pleural thiskening, pulmonary fibrosis and increase in size of lymph nodes.

In your X-ray report, there is evidence of hilar lymph node enlargement. This is the part of the disease process.
Increase in brochovascular markings are normal markings in lung fields which are increased in case of infection or inflammation.
Rheumatoid arthritis is a chronic inflammation whiich may be responsible for increased markings in lumg fields.

Rest of the findings- prominent aortic knuckle may be due to atherosclerosis which is common in elderly people.
Rest of the findings- clear costo-phrenic angles and normal cardio-thoracic ratio are normal findings.

Thanks and take care
Dr Shailja P Wahal
Answered: Mon, 15 Oct 2012
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Radiologist Dr. Kanchanmani's  Response
Accentuted bronchovascular markings is a vague term. Unfolding of aorta is normal in elderly patients. The point of concern in your report is ? lymph node. You can have CT Chest done if symptoms persist.
Interstitial lung disease is more commonly found in Rheumatoid arthritis patients.
Answered: Tue, 16 Oct 2012
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