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ENT · Larynx: relapsing polychondritis
Sample itemA 45-year-old has recurrent painful red swelling of both pinnae sparing the lobules, saddle nose deformity, scleritis and a progressively hoarse voice with inspiratory stridor. What is the diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Relapsing polychondritis
Relapsing polychondritis is an immune-mediated inflammation of cartilage that affects ear, nose, laryngotracheal tree and joints, and the lobule is spared because it lacks cartilage. Airway collapse is the most dangerous complication. Treatment is with corticosteroids and immunosuppressants.
Option by option
A. Relapsing polychondritis (correct)
Correct. Sparing of the lobule with nasal, ocular and airway involvement is typical.
B. Perichondritis from trauma only
Trauma does not explain multisystem cartilage disease.
C. Granulomatosis with polyangiitis
Granulomatosis with polyangiitis often has the lobule involved less specifically and has renal and pulmonary signs and ANCA positivity.
D. Chondrodermatitis nodularis helicis
Chondrodermatitis is a painful nodule on the helix, not a systemic disease.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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