Relapsing polychondritis — SCE Rheumatology MCQ

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HardVasculitisRelapsing polychondritisSCE Rheumatology

A 62-year-old woman with relapsing polychondritis develops exertional stridor and cough. She has recurrent auricular chondritis and saddle-nose deformity. Oxygen saturation is 95% at rest. Chest radiograph is normal. What is the most important complication to screen for?

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Correct answer: B — Tracheobronchomalacia

Explanation lettering: C = shown as A · E = shown as B · A = shown as C · B = shown as D · D = shown as E

Tracheobronchomalacia is best because relapsing polychondritis can involve laryngotracheobronchial cartilage and cause airway collapse. A is less suitable because renal tubular acidosis is associated with Sjögren disease; B is less suitable because urate stones are gout complications; C is less suitable because APS causes thrombosis but does not explain cartilage disease and stridor; D is less suitable because Achilles rupture is not linked to auricular and airway chondritis. Clinical pearl: stridor in relapsing polychondritis is an airway emergency even with a normal chest radiograph.

Reference: Oxford Textbook of Rheumatology