J Korean Rheum Assoc.  2009 Jun;16(2):161-166. 10.4078/jkra.2009.16.2.161.

A Case of Ankylosing Spondylitis with Cricoarytenoid Arthritis

Affiliations
  • 1Department of Internal Medicine, Wallace Memorial Baptist Hospital, Busan, Korea. choong@wmbh.co.kr

Abstract

The cricoarytenoid joint is a diathrodial synovial joint and it can be affected by various diseases. The etiology includes infectious, rheumatic and degenerative diseases. Cricoarytenoid arthritis that's caused rheumatoid arthritis is the most well known, yet cricoarytenoid arthritis that's caused by ankylosing spondylitis is very rare. Hoarseness, dysphagia, throat discomfort, dyspnea and dyspnea on exertion are the major symptoms. If there was no severe airway obstruction, this condition can be managed by systemic steroid or intraarticular steroid injection. We experienced a case of a 47 years old man with ankylosing spondylitis and he presented with hoarseness, dyspnea on exertion and dysphagia. He was finally diagnosed with cricoarytenoid arthritis and he improved after etanercept administration. So we report here on this case along with a review of relevant literature.

Keyword

Spondylitis; Ankylosing; Arthritis; Cricoarytenoid; Etanercept

MeSH Terms

Airway Obstruction
Arthritis
Arthritis, Rheumatoid
Deglutition Disorders
Dyspnea
Etanercept
Hoarseness
Immunoglobulin G
Joints
Pharynx
Receptors, Tumor Necrosis Factor
Spondylitis
Spondylitis, Ankylosing
Immunoglobulin G
Receptors, Tumor Necrosis Factor

Figure

  • Fig. 1. Lateral neck X-ray showed downward displacement of the epiglottis (circle).

  • Fig. 2. (A) Normal position pelvis X-ray showed bilateral sacroiliitis (grade 2). (B) Multiple post-contrast enhancements along the endplate of the vertebral bodies are shown on TL-spine MRI.

  • Fig. 3. There was increased uptake at the anterior neck (arrow), C and T-spines, sternum, and both SI joints on bone spect scan.

  • Fig. 4. Epiglottis and larynx were swollen and erythematous. Movement of the vocal cords was decreased.

  • Fig. 5. The clinical parameters and therapeutic modalities are summarized.


Reference

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