CERTAIN UNUSUAL RADIOLOGICAL APPEARANCES IN THE CHEST OF COAL-MINERS SUFFERING FROM RHEUMATOID ARTHRITIS
CERTAIN UNUSUAL RADIOLOGICAL APPEARANCES IN THE CHEST OF COAL-MINERS SUFFERING FROM RHEUMATOID ARTHRITIS
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DOI：
10.1136/thx.8.1.29
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发表时间：
1953-01-01
期刊：
影响因子：
10
通讯作者：
CAPLAN, A
中科院分区：
文献类型：
--
作者：
CAPLAN, A
大约两年前，人们观察到患有类风湿性关节炎的煤矿工人的胸部X线照片中出现大量阴影的发生率似乎过高。这一观察结果被认为值得进一步调查。从1950年6月至1952年4月，在卡迪夫肺尘埃沉病医疗小组所见的约14，000名肺尘埃沉病伤残津贴申领人中，有51人经检查发现患有类风湿性关节炎，发病率约为0.4%。51例中约90%的病例表现为大面积纤维化，这证实了关节炎中大块阴影发生率高的原始印象。相比之下，在所有接受检查的男性中，大面积纤维化的发生率约为30%。还注意到约25%的关节炎患者胸部影像学阴影是一种特殊类型，通常很容易与进行性大块纤维化（PMF）的常见表现区分开来（弗莱彻，1948）。没有参考文献中发现这种不寻常的放射学表现，本文提出的目的是提请注意与类风湿性关节炎在煤矿工人的肺部变化。风湿性关节炎的放射学外观的特点是存在多个，界限分明，圆形的阴影，0.5至5厘米。在直径上，分布在整个两个肺野，但特别是在外周（图1和图2）。第1-3段）。在这些病例中的一个重要发现是，背部。单纯性尘肺的发病率常为轻度或无（1或0类）。也有证据表明，混浊出现迅速，即在几个月内，并往往保持静止，在大多数情况下，但不是所有的情况。这些表现与进行性大块纤维化的不同之处在于
Some two years ago it was observed that the incidence of massive shadows in chest radiographs of coal-miners suffering from rheumatoid arthritis appeared to be unduly high. The observation was thought to warrant further investigation. From June, 1950, to April, 1952, of about 14,000 claimants for pneumoconiosis disablement benefit seen at the Cardiff Pneumoconiosis Medical Panel, 51 were found on examination to be suffering from rheumatoid arthritis, an incidence of about 0.4%. The original impression of the high incidence of massive shadows in arthritics was confirmed in that about 90% of the 51 cases showed massive fibrosis. This compares with an incidence of about 30% of massive fibrosis in all men examined. It was also noticed that in about 25% of the arthritics the radiological opacities in the chest were of a peculiar type and often easily distinguishable from the usual appearances of progressive massive fibrosis (PMF)(Fletcher, 1948). No reference has been found in the literature to this unusual radiological appearance, and this paper is presented with the object of drawing attention to the lung changes associated with rheumatoid arthritis in coal-miners.THE CHARACTERISTIC RADIOLOGICAL APPEARANCE The characteristic feature is the presence of multiple, well-defined, round opacities, 0.5 to 5 cm. in diameter, distributed throughout both lung fields but particularly at the periphery (Figs. 1-3). An important finding in these cases is that the back-. ground of simple pneumoconiosis is often slight or absent (category* 1 or 0). Evidence is also available that the opacities appear rapidly, that is, within months, and tend to remain stationary in most but not all cases. The differences between these appearances and those seen in progressive massive fibrosis are