Hiroaki Ishikawa, Yuichi Machishima, Hiroaki Tachi, Seiji Mogi, Ai Hosaka, Takashi Mamiya, Taichi Hayashi, Hideo Terashima and Shinji Teramoto
We report the case of a 50-year-old man who presented with organizing pneumonia (OP) as the first manifestation of rheumatoid arthritis (RA). He experienced repeated episodes of pneumonia, which did not respond to several antibiotics. The lymphocyte dominant cell increase in the bronchoalveolar lavage fluid on chest computerized tomography suggested OP. Although he did not present with articular symptoms, magnetic resonance imaging (MRI) revealed synovitis of the hand joints without joint erosion, suggesting that this was a case of early stage RA. The MRI may be a useful diagnostic tool in asymptomatic patients with early stage RA.