# Trapped Lung: A Rare Complication of Rheumatoid Arthritis

## TL;DR

Trapped lung is a rare but serious complication of rheumatoid arthritis that requires careful diagnosis and tailored management.

## Contribution

The paper highlights the importance of recognizing trapped lung in RA patients with chronic pleural issues.

## Key findings

- Trapped lung can present with chronic hydro-pneumothorax and pleural tethering in RA patients.
- Conservative management is an option for patients with poor functional reserve and stable symptoms.
- Surgical decortication is the definitive treatment for trapped lung when feasible.

## Abstract

Trapped lung is a rare complication of rheumatoid arthritis (RA), often resulting from chronic pleural inflammation and fibrosis. It presents as a non-expandable lung with persistent pleural separation despite drainage. We report a 67-year-old woman with seropositive RA and multiple co-morbidities, who presented with chronic left-sided hydro-pneumothorax to the respiratory clinic. Imaging showed pleural thickening, lung nodules, and pleural tethering in addition to the pneumothorax. Due to poor functional reserve, multiple lung nodules and stable symptoms, she was managed conservatively after multidisciplinary input. Trapped lung should be considered in RA patients with chronic pleural effusion and non-resolving pneumothorax. Diagnosis relies on imaging and clinical picture. There are multiple treatment options, with surgical decortication as the definitive modality. Management is planned according to symptom burden and patient suitability for invasive intervention.