Adults
Relapsing polychondritis
Recurrent painful red swelling of the ear (sparing the lobe), nasal bridge or airway cartilage.
What to look for
- Auricular chondritis that spares the earlobe, and nasal chondritis (saddle nose)
- Tracheobronchial involvement: hoarseness, cough, stridor
- Inflammatory arthritis, eye inflammation, hearing loss or vertigo
- In men over 50 with cytopenias, consider VEXAS
What to do
- Send ESR, CRP, CBC and a metabolic panel.
- Stridor, breathing difficulty or rapidly worsening hoarseness can mean airway narrowing: same-day emergency or ENT assessment.
- With stable respiratory symptoms, assess the airway (PFTs with flow-volume loops, CT airway). Stable airway involvement is urgent.
About this urgency level
Specialist evaluation helps, but these are usually less time-sensitive than new inflammatory arthritis or connective tissue disease.
Timeframes are typical targets. Local pathways, capacity and clinical judgment come first.