Screening for small-airway dysfunction in rheumatoid arthritis: impulse oscillometry detects cases missed by spirometry and chest CT scan

Extract Despite therapeutic advances in rheumatoid arthritis (RA), pulmonary complications remain a concern and account for a substantial proportion of RA-related mortality [1]. RA can involve all lung compartments – airways, parenchyma, vasculature, and pleura – but interstitial lung disease (ILD) is among the most recognized and clinically impactful manifestations [2]. Airway involvement, including preclinical emphysema and small-airway dysfunction (SAD) is under-recognized; it often precedes ILD in RA, and therefore warrants greater attention for early assessment and risk-modification strategies [3, 4].