Resident's Page

Abstract

A 50-year-old woman presented with progressive hoarseness of three months' duration and exertional dyspnea of six months' duration. The patient denied having cough, hemoptysis, weight loss, otalgia, and dysphagia. The patient did not use cigarettes or alcohol. The medical history was remarkable for arthritis treated with tolmetin sodium and indomethacin.Physical examination revealed a saddle-nose deformity (Fig 1), arthritic changes in the hands at the distal and proximal interphalangeal joints, and polypoid degeneration of the vocal cords. Admission chest roentgenogram, complete blood cell count, electrolyte levels, and electrocardiogram were normal. The antinuclear