The benefits of ultrasonography in diagnosing and assessing auricular chondritis, arthritis, and tenosynovitis in a patient with relapsing polychondritis

Abstract

A 72-year-old female patient with relapsing polychondritis (RP) with auricular chondritis, arthritis, and tenosynovitis, was evaluated by ultrasonography (US). On US of the auricle, epidermis, dermis, subcutaneous tissue, and cartilage were observed separately. US of the RP auricle revealed (1) increased subcutaneous tissue thickness, (2) reduced echogenicity of the thickened subcutaneous tissue, (3) power Doppler (PD) signals in the subcutaneous tissue, particularly near the cartilage. These US findings were consistent with histological findings. US also demonstrated hypoechoic synovial thickening of the joints and hypoechoic tendon sheath widening with PD signals, which were indicative of arthritis and tenosynovitis, respectively. After treatment, PD signals disappeared, and hypoechoic thickening of auricle, joints, and tendon sheaths was normalised. As US provides objective visual information of inflammation in the auricle, joint, and tendon sheath in RP, US imaging is useful for diagnosing RP and assessing disease activity.

Keywords:

• Arthritis
• auricular chondritis
• relapsing polychondritis
• tenosynovitis
• ultrasonography

Acknowledgements

The authors would like to thank Drs. Akiko Iwase and Mikihide Ogasawara who provided the clinical information of the patient. We also thank Ms. Noralyn Dudt for secretarial assistance.

Conflict of interest

None.