Which physical findings are characteristic of respiratory tract chondritis in relapsing polychondritis (RP)?

Updated: Dec 06, 2018
  • Author: Nicholas Compton, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Respiratory tract involvement affects 40%-56% of patients with relapsing polychondritis and may involve any portion of the respiratory tree, including the distal bronchi. Findings may include the folllowing:

  • Tenderness to palpation may occur over the anterior trachea or thyroid cartilage

  • Chondritis weakens the tracheal cartilage rings, resulting in wheezing, dyspnea, cough, and hoarseness

  • The upper airways can eventually become stenosed and are replaced by collapsible fibrotic tissue. Airways superior to the thoracic inlet collapse upon inspiration, and airways below the thoracic inlet collapse upon expiration; therefore, both inspiratory stridor and expiratory wheezing may be noted on auscultation

  • Inflammation and swelling of the glottis, larynx, and subglottic tissues may require tracheostomy

  • Acute inflammation of the distal airways can lead to obstruction and recurrent pneumonia


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