Rheumatoid Arthritis of the Cricoarytenoid Joints:  Cause of Upper Airway Obstruction

ARTHRITIS involving the larynx has been recorded by various observers since the late 1800's. Initially its cause was usually attributed to infection ^1,2 or trauma,³ although a few authors suggested a rheumatic cause.^4-7 However, in 1955 Montgomery ⁸ reported four cases and specifically emphasized rheumatoid arthritis as the cause. A recent experience is presented to illustrate the life-threatening nature of this condition when laryngeal obstruction occurs, together with comments concerning its diagnosis and management.

Report of Case  A 57-year-old white man was hospitalized at the Pittsburgh Veterans Administration Hospital on Oct 12, 1964, because of far advanced rheumatoid arthritis and chronic leg ulcers. The arthritis was of 18 years' duration and had resulted in contractures of the lower extremities which confined him to a wheelchair. On several occasions in the three months prior to admission, he had experienced episodes of shortness of breath which he characterized as