Acute cricoarytenoid arthritis: local periarticular steroid injection

Acute cricoarytenoid arthritis is a frequent complication of rheumatoid arthritis and the most frequent otolaryngologic manifestation of the disease. Over 25% of rheumatoid arthritis cases have discomfort from this problem. Other etiologies can produce cricoarytenoid arthritis. Symptoms range from mild discomfort through hoarseness to complete airway obstruction requiring emergency tracheotomy. Chronic cricoarytenoid arthritis may result in joint ankylosis and vocal fold fixation. Single periarticular triamcinolone injections may bring rapid and dramatic relief of the symptomatology of nonankylosed acute cricoarytenoid arthritis for periods of up to one year if other medical management is adequate. Six cases illustrate the problem and the efficacy of this treatment methodology. Findings, pathology and pertinent literature are discussed. Specific criteria for considering this technique are outlined. This form of therapy has not been described previously.