Clinical Implications of Ultrasonography (US) in Monitoring Disease Activity of Relapsing Polychondritis (RP) and Comparative Investigation By US between Auricle of RP, Repeated Trauma and Healthy Subject

Eri Amano¹, Yoshinori Taniguchi², Satoshi Inotani¹, Hirofumi Nishikawa¹, Tatsuki Matsumoto³, Shuichi Nakayama⁴ and Yoshio Terada⁵, ¹Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi Medical School, Nankoku, Japan, ²Endocrinology, Metabolism,Nephrology and Rheumatology, Kochi University, Kochi, Japan, ³Endocrinology, Metabolism, Nephrology and Rheumatology, Kochi University, Nankoku, Japan, ⁴Kochi Medical School, Nankoku, Japan, ⁵Kochi University, Nankoku, Japan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Imaging, polychondritis and ultrasonography

Session Information

Date: Monday, November 6, 2017

Session Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Relapsing polychondritis (RP) is a rare systemic inflammatory disorder and might often be refractory. Therefore, the discovery of more convenient imaging modality than contrast-CT, MRI and FDG-PET/CT would be required on diagnosis and treatment. The objective is to assess the clinical implications of ultrasonography (US) in monitoring disease activity and diagnosis of RP.

Methods: Firstly, auricular chondritis of patients with RP (n=5) were assessed by US before and after treatments. Second, the relationship between US findings and other serum inflammatory markers were evaluated. Moreover, the comparisons of US findings between the auricle of patients with RP (n=5), repeated trauma (n=5) which is similar to auricle of RP, and healthy subjects (n=5) were also assessed.

Results: US of the auricular chondritis before treatment showed low-echoic swollen auricular cartilage with increased power Doppler signals (PDS) in all cases. US findings corresponded to biopsy findings. After treatment with prednisolone (PSL) combined with methotrexate, the swollen ear completely resolved in all cases. Then, US findings also showed dramatic reductions in swollen cartilage with the decrease in PDS. When serum inflammatory markers completely improved, but US finding remained, 1 of 5 cases showed flare due to PSL tapering. On the other hands, US imaging could differentiate between inflammation, vascular lesions, and tumors in the ear pinna. RP could be differentiated from the damage of repeated trauma (i.e. rugby) with producing subperichondrial serous effusion.

Conclusion: US imaging of the external ear and auricular cartilage in RP possibly facilitates evaluation of auricular lesions and monitoring of disease activity, especially when we consider the treatment response and the timing of drug tapering.

Disclosure: E. Amano, None; Y. Taniguchi, None; S. Inotani, None; H. Nishikawa, None; T. Matsumoto, None; S. Nakayama, None; Y. Terada, None.

To cite this abstract in AMA style:

Amano E, Taniguchi Y, Inotani S, Nishikawa H, Matsumoto T, Nakayama S, Terada Y. Clinical Implications of Ultrasonography (US) in Monitoring Disease Activity of Relapsing Polychondritis (RP) and Comparative Investigation By US between Auricle of RP, Repeated Trauma and Healthy Subject [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/clinical-implications-of-ultrasonography-us-in-monitoring-disease-activity-of-relapsing-polychondritis-rp-and-comparative-investigation-by-us-between-auricle-of-rp-repeated-trauma-and-healthy-sub/. Accessed August 19, 2018.

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