Joint symptoms in relapsing polychondritis

To study articular symptoms in relapsing polychondritis (RP) and their relationship to other clinical manifestations and prognosis.

Fourteen patients who met the diagnostic criteria proposed by Damiani and Levine for RP were studied. Clinical symptoms were recorded and laboratory and radiologic examinations were carried out. In one patient a synovial histology was obtained.

Twelve patients had joint symptoms affecting the peripheral joints (9), the chondrocostal junctions (5), or both sites together (2). Peripheral arthritis was the most frequent finding, affecting 6 patients, while peripheral arthralgia was the only articular manifestation in 3 patients. The development of joint symptoms (arthralgia, arthritis and costochondritis) was unrelated to the appearance of chondritis at other sites and no correlation was found between articular involvement and age at onset, duration of the disease, number of flares, or severity of the disease, either in terms of the number of organs involved or fatal outcome (p > 0.05). However, when articular symptoms were analysed separately arthritis was associated with a longer duration (50 months vs 30), more affected organs (4.5 vs 3.3) and a poorer prognosis compared with patients with arthralgias alone or chondrocostal symptoms.

Articular symptoms are common in RP but the presence of peripheral arthritis is associated with widespread disease and a poorer prognosis.