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An often overlooked joint in rheumatoid arthritis: cricoarytenoid joint

Purpose: The aim of this study was to assess the prevalence of laryngeal involvement in RA patients, and thus, to increase the awareness of this condition among rheumatologists and otolaryngologists.

Method: A total of 82 subjects with non-smoker, consisting of 42 patients with RA and 40 non-RA patients in the control group, were enrolled in this study. The laryngeal symptoms such as dysphonia, vocal fatigue, foreign body sensation, coughing, dryness, dyspnea, and stridor were assessed in all patients. These patients were screened for laryngeal abnormalities using flexible Nasopharyngolaryngoscope (NFL).

Results: The mean age was 51.7 ± 10.5 years in RA group and 53.8 ± 10.1 years in control group. Concerning laryngeal symptoms, 61.9% patients reported at least one symptom in RA group, 37.5% in the control group. There was a statistically significant difference in the prevalence of coughing, dryness, foreign body sensation and dsypnea among patients with RA versus controls (respectively 42.9% vs. 17.5%, 31% vs. 2.5%, 28.6% vs. 7.5%, 9.5% vs. 0%). The prevalence of NFL alterations was 57.1% in RA patients and 30% in the control group. In RA group, the arytenoid and interarytenoid inflammation were higher compared with control (respectively 50% vs. 12.5%, 54.8% vs. 22.5%).

Discussion: The laryngeal involvement in RA is very common and critical because it can lead to lifethreatening conditions such as airway obstruction. Therefore, early diagnosis has utmost important. We suggest that both the rheumatologists and the otolaryngologists should certainly evaluate the laryngeal symptoms, and moreover, they should get their patients laryngoscopic examinations are made periodically.

Author(s): Bozbas G, Gunel C, Gurer G, Karatas R, Ermisler B