A CASE OF RELAPSING POLYCHONDRITIS PRESENTING AS MEDIASTINAL SYNDROME, DIAGNOSED BY CT SCANS OF THE TRACHEA AND HEAD

Objective. The aim of this study is to evaluate the significance of CT scans of the trachea and head in the diagnosis of Relapsing Polychond ritis (RP). Design. Relapsing polychondritis is a disease involving ca rtilaginous structures, particularly those of the ears, nose and trach ea. Diagnosis is based on specific clinical features and immuno-histop athological evaluation of the cartilages involved. Setting and patient s. We describe a case of RP in which the most evident clinical signs ( cough, dyspnoea, vertigo, tinnitus, headache, oedema of the face and s houlders and fever), led us first to suspect a mediastinal compression syndrome. Intervention. A CT scan of the trachea and head revealed de tails which established the correct diagnosis, supported by other typi cal RP symptoms and by histopathological examination of the cartilage. Main outcome measures. Evaluation by CT scan of the chest, the medias tinum, the head and the pinnae. Results. CT scanning revealed thickeni ng and calcification of the anterolateral tracheal wall and main bronc hi besides marked narrowing of the trachea. CT of the head showed calc ification also of the external auditory meatus and part of the pinnae. Conclusion. We consider that CT scan of the trachea and head is helpf ul in evaluating the bronchial tree, the auditory meatus and pinnae as well as being a valid tool for the final diagnosis and in following t he course of the disease.