Question 24

Question:

A 42-year-old woman with a history of rheumatoid arthritis and seasonal allergies comes to your clinic complaining of pain, erythema, and swelling “on the hard part of my ears.” When questioned, she also describes a low-grade pain in her chest, over her costochondral joints. Which of the following is the most likely diagnosis?

Correct Answer: D.  Relapsing polychondritis

This patient likely has relapsing polychondritis, an autoimmune disorder that may be associated with other autoimmune diseases like rheumatoid arthritis or systemic lupus erythematosus. Patients may complain of bilateral swelling and pain of external ears, nasal cartilage, costochondral joints, and other arthralgias. Involvement of the larynx, trachea, and bronchi may also be reported. Occasionally, cartilage destruction may evolve into deformities like a saddle nose or sagging ears. Other organ systems that may become involved include the cardiovascular system, kidney, and skin.