Reversed halo sign in organizing pneumonia secondary to rheumatoid arthritis

We present a case of a 79-year-old woman who was admitted to our hospital following 15 days of unproductive coughing, moderate fever and asthenia. She was diagnosed with rheumatoid arthritis five years before. CT scan showed multiple and bilateral ground glass opacities surrounded by rings of consolidation, named reversed halo sign (RHS). Pathological specimens led to a diagnosis of OP. The patient was successfully treated with methylprednisolone; the reversed halo sign disappeared. This radiological finding is not considered to be specific for OP, but , it seems to suggest the diagnosis of this disease. To our knowledge, this is the first case of BOOP associated with rheumatoid arthritis presenting with RHS.