ABSTRACT Background: Rheumatoid arthritis (RA) is characterized by symmetrical erosive synovitis and progressive disability, often complicated by extra-articular manifestations especially in seropositive patients, among them, lung involvement is common, and it can include a wide spectrum of disorders, ranging from airways, pleural disease, bronchiectasis, lung nodules, to infection.

Aim of the Work: The aim of this study is to assess HRCT Chest and spirometry test findings in RA Egyptian patients, and their relationship to Methotrexate therapy, disease duration, and activity.

Patients and Methods: This was a cross sectional study which was done on 50 RA patients diagnosed according to Rheumatoid Arthritis - 2010 American college of rheumatology/ European League Against Rheumatism (ACR-EULAR) attending rheumatology and chest inpatient departments and outpatient clinics in Ain Shams University Hospitals.

Results: Patients were divided into two equal groups: Group A: - 25 RA patients treated with MTX only +/- low dose steroid. Group B: - 25 MTX naive RA patients (treated with DMARDs other than MTX) +/- low dose steroid.

Conclusion: We found MTX has no role in RA-ILD, there is no significant difference between MTX users and MTX naïve regarding spirometry and HR-CT.

This was a cross-sectional study which was done on 50 RA patients diagnosed according to Rheumatoid Arthritis - 2010 American college of rheumatology/ European League Against Rheumatism (ACR-EULAR) classification criteria (Aletaha et al., 2010), patients enrolled from rheumatology and chest inpatient departments and outpatient clinics in Ain Shams University Hospitals.

Patients were divided in to two equal groups:

- Group A: - 25 RA patients treated with MTX only +/- low dose steroid

. Group B: - 25 MTX naive RA patients (treated with DMARDs other than MTX) +/- low dose steroid.

Inclusion Criteria:

• Age more than 18 yr rheumatoid arthritis more than one year, all patients were under RA Treatment for more than one year

Exclusion Criteria:

• Patients with recent respiratory infection, history of pulmonary tuberculosis or other chest disorders such as COPD, bronchial asthma, vasculitis, pleural diseases, thromboembolism or pulmonary hypertension, any patient receiving drugs that induce ILD such as chemotherapeutics, antimicrobials, cardiovascular agents.

50 RA patients diagnosed according to Rheumatoid Arthritis - 2010 American college of rheumatology/ European League Against Rheumatism (ACR-EULAR) attending rheumatology and chest inpatient departments and outpatient clinics in Ain Shams University Hospitals.