Elsevier

Clinical Radiology

Volume 35, Issue 3, January–November 1984, Pages 233-236
Clinical Radiology

Rheumatoid arthritis of the crico-arytenoid and crico-thyroid joints: A radiological and clinical study

https://doi.org/10.1016/S0009-9260(84)80146-4Get rights and content

Low-voltage neck radiography and indirect laryngoscopy was performed in 22 randomly selected rheumatoid patients with the purpose of detecting intralaryngeal arthritis. Radiographic evidence of erosive arthritis of the crico-arytenoid (CA) joints was found in 45% of the patients. Clinical acute CA arthritis without erosive changes was present in two patients, the overall incidence of CA arthritis being 55%. The incidence was higher in females (65%) than in males (20%). The CA arthritis was asymptomatic in 58% of the patients. Radiography revealed osseous destruction at the crico-thyroid joint in four females.

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Cited by (33)

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    2015, Advances in Medical Sciences
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    According to Jurik et al. [27] in 45% of RA patients erosive arthritis of the cricoarytenoid (CA) joints in radiological examinations was observed. Simultaneously, the authors noticed that the CA arthritis may be asymptomatic in 58% of patients [27]. Bilateral vocal fold immobility with their medial position may lead to acute airway obstruction requiring surgical intervention [26,28].

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    The yield of imaging technique in the detection of CAJ involvement can go from 25% to 72% depending on the sensitivity of the technique used, with 58% of the patients being asymptomatic.7 In a study by Jurik and Pedersen et al, low-voltage radiography revealed osseous destruction of the CAJ in up to 45% of their 22 patients.8 High-resolution computed tomography (HRCT) scan seems to be more useful for early detection of CAJ arthritis, where the presence of cricoid cartilage erosion is often mistaken for an aggressive carcinoma of the larynx.9

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    Early studies estimated an incidence of 26%.132 In a group of 22 unselected RA patients, radiographic evidence of erosive arthritis of the cricoarytenoid joint was present in 45%, and when indirect laryngoscopy findings were included, 55% of patients were affected.133 Subsequent studies have found an incidence of abnormal findings at laryngoscopy and on CT of the neck ranging between 52% and 75%, although these results may reflect referral bias.134,135

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