- Rheumatoid arthritis is the most common cause of this condition
- Can also may be associated with bacterial infections, mumps, diphtheria, tuberculosis and ankylosing spondylitis,systemic lupus erythematosus, gout, progressive systemic sclerosis
- The cricoarytenoid joint has a synovial lining and bursa. Its mobility is vital for speech, respiration, and protection from aspiration.
- Effusion, pannus formation, joint erosion, and ankylosis may compromise the joint’s functions.
- Its involvement may be unsuspected or mistaken for asthma until intubation or after extubation and may necessitate a surgical airway.
- Dysphonia, dyspnea, or stridor should raise suspicion of this possibility.
- Complete airway obstruction is a well described but an uncommon complication
- Laryngoscopy may reveal a rough and thick mucosa with narrowing of the vocal chink.
- Airway obstruction occurs most commonly in patients with long-standing rheumatoid arthritis with polyarticular and systemic involvement
- But laryngeal stridor has been described as the sole manifestation of this disease too!
- Always anticipate this as a cause for postoperative stridor in such patients.
The Lay Medical Man 