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June 1971

Rheumatoid Arthritis of the Cricoarytenoid Joint

Author Affiliations

Richmond, Va
From the departments of otolaryngology (Drs. Woldorf and Pastore) and surgery (Dr. Terz), Medical College of Virginia, Richmond.

Arch Otolaryngol. 1971;93(6):623-627. doi:10.1001/archotol.1971.00770060925015

A 66-year-old man had rheumatoid arthritis of the right cricoarytenoid joint. The disease is more common than generally believed. The symptoms and signs are hoarseness, dyspnea, stridor, dysphagia, laryngeal tenderness, edema, erythema, and vocal cord fixation. The differential diagnosis includes recurrent laryngeal nerve palsy, trauma with arytenoid subluxation, infection, and neoplasia. The pathology is characteristic of rheumatoid arthritis in other diarthrodial joints. Treatment may include tracheostomy for acute respiratory distress as well as heat, cool humidification of inspired air, and anti-inflammatory agents such as acetylsalicylic acid, phenylbutazone, chloroquine, gold salts, and steroids. Arytenoidectomy with lateral cord fixation may become necessary in chronic cases. A case report is presented in which there was unilateral arytenoid involvement accompanying Felty's syndrome which is characterized by leukopenia, splenomegaly, and rheumatoid arthritis.

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