Relapsing Polychondritis Differential Diagnoses

Updated: Oct 12, 2022
  • Author: Nicholas Compton, MD; Chief Editor: Herbert S Diamond, MD  more...
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DDx

Diagnostic Considerations

Other conditions to consider in the differential diagnosis of polychondritis include the following:

  • Rheumatoid arthritis
  • Polyarteritis nodosa
  • Cogan syndrome
  • Infectious perichondritis
  • MAGIC syndrome (relapsing polychondritis [RP] plus Behçet disease)
  • Trauma (especially in boxers and wrestlers)
  • Congenital syphilis
  • Chronic external otitis
  • Auricular calcification (secondary to other conditions, eg, trauma, Addison disease, diabetes, hyperthyroidism)

Auricular chondritis

Causes include the following:

Inflammatory arthritis

Causes include the following:

  • Rheumatoid arthritis (adult or juvenile)
  • Reactive arthritis
  • Acute gonococcal arthropathy
  • Granulomatosis with polyangiitis (formerly known as Wegener granulomatosis)
  • Polyarteritis nodosa
  • Systemic lupus erythematosus and other collagen-vascular disorders

Nasal chondritis/saddle-nose deformity

Causes include the following:

  • Infectious perichondritis
  • Granulomatosis with polyangiitis (formerly known as Wegener granulomatosis)
  • Congenital syphilis
  • Nasal NK/peripheral T-cell lymphoma (formerly known as angiocentric lymphoma)

Ocular inflammation

Causes include the following:

  • Reactive arthritis (ie, conjunctivitis plus arthritis plus urethritis)
  • Rheumatoid arthritis, Behçet disease, enteropathic arthritis, or Still disease (ie, iritis or chorioretinitis plus arthritis)
  • Polyarteritis nodosa or granulomatosis with polyangiitis (ie, scleritis or episcleritis plus arthritis)
  • Sjögren syndrome (ie, keratoconjunctivitis sicca plus arthritis)
  • Cogan syndrome (ie, intersitial keratitis plus cochlear and vestibular damage)
  • Arteriosclerosis, syphilis, collagen vascular disease, herpes zoster, sickle cell disease, migraine, coagulation disorders (ie, ischemic optic neuropathy)

Tracheal obstruction

Causes include the following:

  • Trauma (eg, strangulation)
  • Prolonged intubation
  • Sarcoidosis
  • Granulomatosis with polyangiitis
  • Endoluminal malignancy
  • Tuberculosis/sarcoidosis webs

Respiratory tree chondritis

Perichondritis of the larynx resulting from any of the following:

  • Herpes
  • Syphilis
  • Erysipelas
  • Tonsillitis
  • Peritonsillar abscess
  • Tuberculosis
  • Measles
  • Diphtheria
  • Scarlet fever
  • Avitaminosis
  • Blastomycosis
  • Actinomycosis
  • Granulomatosis with polyangiitis
  • Xanthoma
  • Typhus
  • Vincent infection
  • Anthrax

CNS alterations

Causes include the following:

  • Septic meningitis (fungal, bacterial, mycobacterial)
  • Aseptic meningitis unrelated to relapsing polychondritis, ie, viral
  • Ménière disease
  • Temporal arteritis
  • Malignancy
  • Drug toxicity
  • Encephalitis or meningoencephalitis
  • Other causes of cerebral vasculitis
  • Other causes of seizure disorder
  • Leprosy

Aortitis

Causes include the following:

Differential Diagnoses