Acute exacerbations of progressive-fibrosing interstitial lung diseases

A 63-year-old woman with rheumatoid arthritis-associated interstitial lung disease who presented to clinic with 2 weeks of increasing shortness of breath. Axial and coronal images show a) baseline computed tomography 1 year before presentation showing reticulation and honeycombing in a definite usual interstitial pneumonia pattern; b) presentation of acute exacerbation of interstitial lung disease with new onset bilateral ground-glass opacities on background of usual interstitial pneumonia and c) follow-up computed tomography 1 week after treatment with high-dose steroids showing some improvement in ground-glass opacification.