Dyspnea with joint pain, ...

A 52-year-old woman diagnosed with rheumatoid arthritis in 2010 and arthritis and lichen planus in 2015 presented to the clinic. She had been referred from a rheumatology outpatient clinic due to a history of progressive shortness of breath with an 8-month duration that was associated with joint pain, swelling, and morning stiffness. The shortness of breath had a gradual onset and was aggravated by exercise or cold weather exposure. It was also accompanied by infrequent episodes of dry cough and wheezing. The patient had no chest pain, rhinorrhoea, epistaxis, fever, or sweating. Moreover, a chest examination revealed normal auscultatory findings. Normal vital signs were detected, and laboratory results showed that antinuclear antibody, complete blood count, erythrocyte sedimentation rate, and C-reactive protein levels were high. A high-resolution CT scan was performed.