ISSN : IJCMI Volume 1 • Issue 2 • 1000145 January, 2014 Clinical Image http://dx.doi.org/10.4172/ijcmi.1000145 International Journal of Clinical & Medical Imaging Title : Rheumatoid Arthritis Under Corticosteroid Therapy Inês Neves 1 , Adriana Magalhães 1 1 Pulmonology Department, Hospital de São João; Faculty of Medicine of Porto University; Centro Hospitalar de São João, Porto Portugal. *Corresponding author: Pulmonology Department, Hospital de São João; Faculty of Medicine of Porto University; Centro Hospitalar de São João, Porto Portugal, E-Mail: [email protected] A 66 year-old female patient, with a history of rheumatoid arthritis under corticosteroid therapy, was admitted to the Pul- monology ward with cavitated pulmonary tuberculosis and a pneumothorax, with high flow bronchopleural air leak. Chest CT revealed pneumomediastinum, loculated right pneumothorax, and a communication, 48X32 cm, between the superior lobar bronchus and a parenchymal cavitation, communicating with the pleural space (Panel A). Fiberoptic bronchoscopy showed a huge hole at the entrance of the posterior segment of the right upper lobar bronchus (Panel B and Panel C), through which it was possible to pass the fiber-bronchoscope and visualize the chest tube inside the pleural cavity (Panel D). She had no had medical conditions to thoracic surgical intervention, and aﬅer 90 days of anti-tuberculosis treatment and thoracic drainage, there was a spontaneous cicatrisation of the fistula. Copyright: © 2014 Neves I . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. A B C D

: C olume ssue Clinical Medical Imaging anuary ttpd.doi ... · : C olume ssue anuary linial Iage ttpd.doi.org1.1icmi.11 International Journal of Clinical Medical Imaging Title: Rheumatoid

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Page 1: : C olume ssue Clinical Medical Imaging anuary ttpd.doi ... · : C olume ssue anuary linial Iage ttpd.doi.org1.1icmi.11 International Journal of Clinical Medical Imaging Title: Rheumatoid

ISSN : IJCMI

Volume 1 • Issue 2 • 1000145

January, 2014

Clinical Image

http://dx.doi.org/10.4172/ijcmi.1000145

International Journal of Clinical & Medical Imaging

Title : Rheumatoid Arthritis Under Corticosteroid TherapyInês Neves1, Adriana Magalhães1

1Pulmonology Department, Hospital de São João; Faculty of Medicine of Porto University; Centro Hospitalar de São João, Porto Portugal.

*Corresponding author: Pulmonology Department, Hospital de São João; Faculty of Medicine of Porto University; Centro Hospitalar de São João, Porto Portugal, E-Mail: [email protected]

A 66 year-old female patient, with a history of rheumatoid arthritis under corticosteroid therapy, was admitted to the Pul-monology ward with cavitated pulmonary tuberculosis and a pneumothorax, with high flow bronchopleural air leak. Chest CT revealed pneumomediastinum, loculated right pneumothorax, and a communication, 48X32 cm, between the superior lobar bronchus and a parenchymal cavitation, communicating with the pleural space (Panel A). Fiberoptic bronchoscopy showed a huge hole at the entrance of the posterior segment of the right upper lobar bronchus (Panel B and Panel C), through which it was possible to pass the fiber-bronchoscope and visualize the chest tube inside the pleural cavity (Panel D). She had no had medical conditions to thoracic surgical intervention, and after 90 days of anti-tuberculosis treatment and thoracic drainage, there was a spontaneous cicatrisation of the fistula.

Copyright: © 2014 Neves I. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A B

C D