Clinical implications of ultrasonography in monitoring disease activity of relapsing polychondritis

Taniguchi, Yoshinori; Nishikawa, Hirofumi; Nakayama, Shuichi; Amano, Eri; Terada, Yoshio

doi:10.1093/rheumatology/kew219

Cited by 4 publications

(3 citation statements)

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“…Recently, ultrasonography of the joints and entheses has been widely used in the diagnosis and evaluation of disease activity of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) 20–25 . Thus, although ultrasonography is widely used clinically in the field of rheumatology, either no or poor consensus exists regarding its usefulness for assessment of chondritis in RP 26,27 . In this study, we retrospectively reviewed changes of auricular and nasal chondritis in 6 patients with RP by ultrasonography before and after treatment to evaluate the usefulness of ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

“… 20 , 21 , 22 , 23 , 24 , 25 Thus, although ultrasonography is widely used clinically in the field of rheumatology, either no or poor consensus exists regarding its usefulness for assessment of chondritis in RP. 26 , 27 In this study, we retrospectively reviewed changes of auricular and nasal chondritis in 6 patients with RP by ultrasonography before and after treatment to evaluate the usefulness of ultrasonography. This study suggested that the ultrasonographic finding of active auricular chondritis in RP revealed perichondral soft‐tissue swelling and PDS enhancement; therefore, ultrasonography could help clinicians diagnose the disease, evaluate disease activity and consider the therapeutic strategy, especially drug tapering, in patients with RP.…”

Section: Discussionmentioning

confidence: 99%

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Ultrasonography of auricular cartilage is a potential tool for diagnosing relapsing polychondritis and monitoring disease activity

et al. 2021

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Aim To assess the clinical utility of ultrasonography in the diagnosis and monitoring of disease activity in relapsing polychondritis (RP). Methods Auricular and nasal chondritis of 6 patients with RP were assessed by ultrasonography before treatment initiation. Changes in the ultrasonographic and clinical findings and serum inflammatory markers were longitudinally assessed. Ultrasonography was also performed in 6 patients with repeat ear trauma, 6 patients with auricular cellulitis and 6 healthy controls for comparison among groups. Results In all cases of RP, ultrasonographic findings before treatment revealed low‐echoic swollen auricular and nasal cartilage and perichondral soft‐tissue with increased power Doppler signals (PDS) corresponding to biopsy findings. After 2‐month treatment with prednisolone (PSL) combined with methotrexate, clinical and serum inflammatory markers were completely resolved. Although swollen perichondral soft‐tissue, cartilage and PDS on auricular ultrasonography were also significantly improved, PDS remained in 2 of 6 cases, which showed flare early after tapering PSL. Finally, ultrasonographic findings of RP were substantially differentiated between patients with repeat trauma and cellulitis and healthy controls based on the thickness of soft tissue around the cartilage, PDS and subperichondral serous effusion. Conclusion Assessment of RP lesions by ultrasonography is useful for the evaluation of cartilaginous lesions and monitoring of disease activity, especially when considering the treatment response and the timing of drug tapering.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ultrasonography of auricular cartilage is a potential tool for diagnosing relapsing polychondritis and monitoring disease activity

et al. 2021

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“…The clinical implications of ultrasonography of the ear pinna in the diagnosis and monitoring of disease activity of RPC have been reported (Figure 7) [88]. Color Doppler ultrasonography is a convenient, rapid, and noninvasive tool for the estimation of tissue inflammation and blood flow.…”

Section: Laboratory Findings and Diagnosismentioning

confidence: 99%

Ocular Involvement in Relapsing Polychondritis

Fukuda

Mizobuchi

Nakajima

et al. 2021

JCM

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Relapsing polychondritis (RPC) is a rare systemic immune-mediated disease characterized by recurrent inflammation of cartilaginous and proteoglycan-rich tissues throughout the body. Auricular, nasal, tracheal, and articular chondritis and arthritis are common systemic symptoms in patients with RPC. Ocular tissues are also targets of inflammation in RPC, and a variety of ocular symptoms are observed in approximately half of the patients with RPC. Scleritis/episcleritis, uveitis, and conjunctivitis are common symptoms associated with RPC. Less frequently, keratitis, retinopathy, optic neuropathy, muscle palsy, and orbital inflammation are also observed. Ocular inflammation could also be the first manifestation of RPC. Although RPC is a potentially fatal and sight-threatening disease, the rarity of the disease and its protean clinical presentation may lead to delayed diagnosis or misdiagnosis. Given the high prevalence of ocular involvement in RPC, to avoid misdiagnosis, physicians should be suspicious of RPC when they see patients with recurrent ocular inflammatory conditions and various systemic symptoms. In this article, we provide a comprehensive review of ocular manifestations associated with RPC.

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