Which diagnostic modalities are useful in detecting and following disease activity and cartilage damage in patients with Relapsing Polychondritis?
At baseline, all patients should undergo an evaluation by an otolaryngologist and obtain baseline pulmonary function studies (with inspiratory/expiratory flow loops), chest radiography as outlined previously, complete blood count (to identify anemia or other abnormalities suggestive of potential hematologic disorder), comprehensive metabolic panel, urinalysis, and ANCA, PR3, and MPO antibody testing.
An ESR and CRP can be useful as well.
If patients have pulmonary symptoms, nasal chondritis (elevated risk of airway disease), or abnormalities on the screening pulmonary studies listed earlier, CT or MRI of the tracheobronchial tree should be performed. Echocardiography is useful in the diagnosis and follow-up of valvular heart disease and aortic root dilatation. MR angiograms should be followed in patients with large artery involvement. Positron emission tomography has been evaluated in small research studies and may provide more accurate staging of disease as well as monitoring response to therapy, but it has not been compared with less costly imaging modalities; therefore, it is not routinely used in clinical practice. Consider a referral to ophthalmology for baseline evaluation.
