CTICasesRelapsing Polychondritis with Tracheal and Costal Cartilage Involvement
Imaging findings
CT in a patient in their 40s demonstrates circumferential tracheal wall thickening with calcification and luminal narrowing extending over a long segment. There is associated calcification of the costal cartilage in a pattern and distribution unusual for the patient's age. The combination of tracheal wall thickening with calcification and premature/excessive cartilage calcification at the costochondral junctions is characteristic of relapsing polychondritis with tracheal and thoracic cartilage involvement.
Key takeaways
Relapsing polychondritis is an autoimmune inflammatory condition that attacks cartilaginous structures including the trachea, bronchi, ear cartilage, and rib cartilage. CT findings include circumferential tracheal and bronchial wall thickening with or without calcification (anterior sparing of the posterior membranous wall helps distinguish it from other forms of tracheobronchopathy), and premature heavy calcification of the costal cartilages. Recognition of this combination on CT should prompt clinical correlation for the diagnosis of relapsing polychondritis, which is treated with immunosuppression to prevent progressive airway damage.
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