The diagnosis of RA was formerly based on detection of<unk>  factor (RF). However, RF is also associated with other autoimmune diseases. The detection of anti-CCP is currently considered the most specific marker of RA. The diagnosis of<unk>  is based on evaluation of pulmonary function, radiology, serology and<unk>  biopsy. High resolution CT scans are preferred to chest X-rays due to their sensitivity and specificity. Associated doctors to diagnosis this properly would be a Rheumatologists or Pulmonologist. Within a physical examination doctors could find possible indications, such as hearing crackles (rales) when listening to the<unk> s with a stethoscope. Or, there may be decreased breath sounds, wheezing, a rubbing sound, or normal breath sounds. When listening to the heart, there may be abnormal heart sounds. Bronchoscopic, video-assisted, or open<unk>  biopsy allows the histological characterization of pulmonary lesions, which can distinguish<unk>  from other interstitial<unk>  diseases. The following tests may also show signs of<unk> : * Chest x-ray may show: * pleural effusion * lower zone predominant reticular or reticulonodular pattern * volume loss in advanced disease * skeletal changes, e.g. erosion of clavicles, glenohumeral erosive arthropathy, superior rib notching * Chest CT or HRCT features include: * pleural thickening or effusion * interstitial fibrosis * bronchiectasis * bronchiolitis obliterans * large<unk>  nodules * single or multiple * tend to be based peripherally * may cavitate (necrobiotic<unk>  nodules) * cavitation of a peripheral nodule can lead to pneumothorax or haemopneumothorax. * follicular bronchiolitis * small centrilobular nodules or tree-in-bud * rare * Caplan syndrome * Echocardiogram (may show pulmonary hypertension) *<unk>  biopsy (bronchoscopic, video-assisted, or open), which may show pulmonary lesions *<unk>  function tests * Needle inserted into the fluid around the<unk>  (thoracentesis) * Blood tests for<unk>  arthritis
Rheumatoid lung disease
Mineral dust airway disease
Alcoholic lung disease
Allergic bronchopulmonary aspergillosis
Idiopathic pulmonary fibrosis
Bronchiectasis
Alveolar lung disease
Plastic bronchitis