A 67-year-old man has a long history of symmetrical small joint arthritis with deformities. He now develops shortness of breath on exertion with a dry cough, but no sputum or chest discomfort. His heart sounds have a loud P2, and the lungs have fine bibasilar crackles. Which of the following is the most likely diagnosis of the pulmonary condition associated with his arthritis?

In RA, pleural involvement is very common at autopsy but infrequently causes symptoms. Interstitial lung disease (ILD) is the most common manifestation of rheumatoid lung disease. RA associated interstitial lung disease (RA-ILD) is usually similar to idiopathic pulmonary fibrosis (IPF) in terms of its clinical presentation, pathology, disease spectrum, and pathogenesis. Presentation is more common at age 50-60 years, in men (M:F=2-3:1), and in association with seropositive and erosive joint disease. If pleural fluid is present, glucose levels are very low.