Chest abnormalities in juvenile-onset mixed connective tissue disease: assessment with high-resolution computed tomography and pulmonary function tests.

BACKGROUND: Mixed connective tissue disease (MCTD) is associated with several chest manifestations. Only a few studies have focused on chest manifestations in juvenile-onset MCTD (jMCTD), and the true prevalence of pulmonary abnormalities on high-resolution computed tomography (HRCT) in these patients is unknown. PURPOSE: To investigate the occurrence of pulmonary abnormalities in jMCTD with particular reference to interstitial lung disease (ILD), and to evaluate a possible association between pulmonary findings and disease-related variables. MATERIAL AND METHODS: Twenty-four childhood-onset MCTD patients with median disease duration of 10.5 years (range 1-21 years) were investigated in a cross-sectional study by means of HRCT, pulmonary function tests (PFT), and clinical assessment. RESULTS: Discrete ILD was identified in six patients (25%). Median extent of ILD was 2.0%, and all except one of the patients had very mild disease in which 5% or less of the parenchyma was affected. The CT features of fibrosis were mainly microcystic and fine intralobular. The most frequently abnormal PFT was carbon monoxide uptake from the lung, which was abnormal in 33% of the patients. PFT and disease duration were not significantly associated with HRCT findings of ILD. CONCLUSION: The prevalence of ILD in childhood-onset MCTD patients was lower than previously believed. In most of the patients with ILD, the findings were subtle and without clinical correlation. The results suggest a low extent of ILD in childhood-onset MCTD, even after long-term disease duration.

Complications following ultrasound-guided thoracocentesis.

PURPOSE: To retrospectively register the number and type of complications following ultrasound-guided thoracocentesis, and to evaluate the need for routine chest X-ray after the procedure. MATERIAL AND METHODS: Complications were retrospectively registered from the radiological and clinical reports of 371 consecutive patients who had undergone thoracocentesis with a total of 711 procedures. RESULTS: The mean volume evacuated was 823ml (range 0-3600ml). Twenty (2.8%) pneumothoraces were found after 711 thoracocenteses, but in no case was chest tube drainage necessary. Hemoptysis occurred in one patient. CONCLUSION: Ultrasound-guided thoracocentesis was found to be a safe procedure. Based on these results, no reason was found to introduce an upper limit of the amount of fluid drained in one session. Routine follow-up chest X-ray is not justified in the absence of clinical symptoms.