Table of ContentsView AllTable of ContentsAnatomy and FunctionSymptomsCauses and Risks FactorsDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Anatomy and Function
Symptoms
Causes and Risks Factors
Diagnosis
Treatment
Cricoarytenoidarthritis (CA) is a rare complication of rheumatoid arthritis (RA) that can cause symptoms such as hoarseness, painful swallowing, feeling like something is stuck in your throat, shortness of breath, loud breathing, and airway obstruction. The cricoarytenoid joints are a pair of small joints in the back wall of thelarynx (voice box). These joints open, close, and tighten the vocal cords during speech and breathing.
Ariel Skelley / Getty Images
Anatomy and Function of Cricoarytenoid Joints
Rheumatoid arthritis is an autoimmune condition where the body attacks the synovium, causing inflammation in and around the joints. RA of the cricoarytenoid joints can not only affect your voice but can impact breathing as well.
The cricoarytenoid joints are two small joints in the back of the larynx between thecricoidandarytenoidcartilage. These joints are used to manipulate the vocal cords when you talk, sing, hum, or breathe.
Not everyone who has abnormalities involving the cricoarytenoid joint experiences symptoms, and the reasons behind this are not well understood. In some cases, symptoms begin even before there are observable changes in the joint.
Symptoms of cricoarytenoid arthritis include:
If you have these symptoms, don’t pass them off as being something minor. Sometimes the hoarseness and breathing problems are the only signs that someone has RA or another rheumatic disease.
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Causes and Risk Factors
When this happens in the cricoarytenoid joint, it becomes less able to move the vocal cords or assist in breathing.Studies show cricoarytenoid joint involvement occurs in up to 75% of people with RA.
Cricoarytenoid arthritis is most common in people with RA, but it can also occur in otherautoimmune diseases, including:
When cricoarytenoid arthritis occurs as part of a previously diagnosed disease, healthcare providers may use various imaging techniques to look at the larynx, including:
A physical exam will likely include palpating (pushing on and manipulating) the cricoarytenoid joint to see if it’s stiff or rigid.
Because cricoarytenoid arthritis is a consequence of other diseases,treating the underlying diseasemay help ease symptoms. This could include the use of immunosuppressive and anti-inflammatory medications.
Specific treatment for mild symptoms of cricoarytenoid arthritis usually begins with high-dose systemiccorticosteroids.If that doesn’t work, an injection of corticosteroids into the cricoarytenoid joint may be required.
In certain situations in which the arthritis is interfering with breathing or speech and not responding to other treatments, surgery may be an option. Possible procedures include:
Precautions for SurgeryIf you have cricoarytenoid joints and need to be intubated for surgery, precautions need to be taken to prevent the procedure from causing further damage.
Precautions for Surgery
If you have cricoarytenoid joints and need to be intubated for surgery, precautions need to be taken to prevent the procedure from causing further damage.
Summary
RA is the most common condition associated with cricoarytenoid arthritis. Signs of cricoarytenoid arthritis include hoarseness, stridor, and pain when swallowing, talking, or coughing. It is diagnosed using imaging tests, such as a laryngoscopy or CT scan, along with a physical exam and blood work.
When RA is the underlying cause of cricoarytenoid arthritis, it is treated with immunosuppressive and anti-inflammatory medications. If it is interfering with your breathing, surgery may be needed to keep your airways open.
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pradhan P, Bhardwaj A, Venkatachalam VP.Bilateral cricoarytenoid arthritis: a cause of recurrent upper airway obstruction in rheumatoid arthritis.Malays J Med Sci. 2016;23(3):89-91.Izuka S, Kaneko S, Harada T, et al.Cricoarytenoid arthritis in rheumatoid arthritis. Rheumatology. 2021;60(8):3955-3955. doi: 10.1093/rheumatology/keaa838National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Stridor.Ohio State University Wexner Medical Center: PathologyOutlines.com.Bone & joints: Arthritis, rheumatoid arthritis.Farah C, Tabesh OA, Okais J, Hajjar A, Haddad A.Cricoarytenoid joint arthritis: A possible complication of dermatomyositis.Pan Afr Med J. 2020;36:74. Published 2020 Jun 9. doi:10.11604/pamj.2020.36.74.18891National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Autoimmune disorders.Abdel Razek AA.Imaging of connective tissue diseases of the head and neck.Neuroradiol J. 2016;29(3):222–30. doi:10.1177/1971400916639605U.S. National Library of Medicine: MedlinePlus.Laryngoscopy and nasolaryngoscopy.Joshi AA, Velecharla MS, Patel TS, Shah KD, Bradoo RA.Management of difficult laryngeal exposure during suspension microlaryngoscopy.Indian J Otolaryngol Head Neck Surg. 2019;71(1):81-85. doi:10.1007/s12070-018-1481-6U.S. National Library of Medicine: MedlinePlus.Electromyography.Hamdan AL, Khalifee E, Berjawi G.Unilateral cricoarytenoid joint ankylosis in rheumatoid arthritis.Ear Nose Throat J. 2020;99(1):11-12. doi:10.1177/0145561319825734Eddaoudi M, Rostom S, Amine B, Bahiri R.The involvement of vocal cords in rheumatoid arthritis: A clinical case.Pan Afr Med J. 2019;34:102. Published 2019 Oct 21. doi:10.11604/pamj.2019.34.102.20490Iacovou E, Vlastarakos PV, Nikolopoulos TP.Laryngeal involvement in connective tissue disorders. Is it important for patient management?Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):22-29. doi:10.1007/s12070-012-0491-zYılmaz T, Altuntaş OM, Süslü N, et al.Total and partial laser arytenoidectomy for bilateral vocal fold paralysis.Biomed Res Int. 2016;2016:3601612. doi:10.1155/2016/3601612Additional ReadingMaini RN, Venables PJW.Patient information: Rheumatoid arthritis symptoms and diagnosis.
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Pradhan P, Bhardwaj A, Venkatachalam VP.Bilateral cricoarytenoid arthritis: a cause of recurrent upper airway obstruction in rheumatoid arthritis.Malays J Med Sci. 2016;23(3):89-91.Izuka S, Kaneko S, Harada T, et al.Cricoarytenoid arthritis in rheumatoid arthritis. Rheumatology. 2021;60(8):3955-3955. doi: 10.1093/rheumatology/keaa838National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Stridor.Ohio State University Wexner Medical Center: PathologyOutlines.com.Bone & joints: Arthritis, rheumatoid arthritis.Farah C, Tabesh OA, Okais J, Hajjar A, Haddad A.Cricoarytenoid joint arthritis: A possible complication of dermatomyositis.Pan Afr Med J. 2020;36:74. Published 2020 Jun 9. doi:10.11604/pamj.2020.36.74.18891National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Autoimmune disorders.Abdel Razek AA.Imaging of connective tissue diseases of the head and neck.Neuroradiol J. 2016;29(3):222–30. doi:10.1177/1971400916639605U.S. National Library of Medicine: MedlinePlus.Laryngoscopy and nasolaryngoscopy.Joshi AA, Velecharla MS, Patel TS, Shah KD, Bradoo RA.Management of difficult laryngeal exposure during suspension microlaryngoscopy.Indian J Otolaryngol Head Neck Surg. 2019;71(1):81-85. doi:10.1007/s12070-018-1481-6U.S. National Library of Medicine: MedlinePlus.Electromyography.Hamdan AL, Khalifee E, Berjawi G.Unilateral cricoarytenoid joint ankylosis in rheumatoid arthritis.Ear Nose Throat J. 2020;99(1):11-12. doi:10.1177/0145561319825734Eddaoudi M, Rostom S, Amine B, Bahiri R.The involvement of vocal cords in rheumatoid arthritis: A clinical case.Pan Afr Med J. 2019;34:102. Published 2019 Oct 21. doi:10.11604/pamj.2019.34.102.20490Iacovou E, Vlastarakos PV, Nikolopoulos TP.Laryngeal involvement in connective tissue disorders. Is it important for patient management?Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):22-29. doi:10.1007/s12070-012-0491-zYılmaz T, Altuntaş OM, Süslü N, et al.Total and partial laser arytenoidectomy for bilateral vocal fold paralysis.Biomed Res Int. 2016;2016:3601612. doi:10.1155/2016/3601612Additional ReadingMaini RN, Venables PJW.Patient information: Rheumatoid arthritis symptoms and diagnosis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Pradhan P, Bhardwaj A, Venkatachalam VP.Bilateral cricoarytenoid arthritis: a cause of recurrent upper airway obstruction in rheumatoid arthritis.Malays J Med Sci. 2016;23(3):89-91.Izuka S, Kaneko S, Harada T, et al.Cricoarytenoid arthritis in rheumatoid arthritis. Rheumatology. 2021;60(8):3955-3955. doi: 10.1093/rheumatology/keaa838National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Stridor.Ohio State University Wexner Medical Center: PathologyOutlines.com.Bone & joints: Arthritis, rheumatoid arthritis.Farah C, Tabesh OA, Okais J, Hajjar A, Haddad A.Cricoarytenoid joint arthritis: A possible complication of dermatomyositis.Pan Afr Med J. 2020;36:74. Published 2020 Jun 9. doi:10.11604/pamj.2020.36.74.18891National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Autoimmune disorders.Abdel Razek AA.Imaging of connective tissue diseases of the head and neck.Neuroradiol J. 2016;29(3):222–30. doi:10.1177/1971400916639605U.S. National Library of Medicine: MedlinePlus.Laryngoscopy and nasolaryngoscopy.Joshi AA, Velecharla MS, Patel TS, Shah KD, Bradoo RA.Management of difficult laryngeal exposure during suspension microlaryngoscopy.Indian J Otolaryngol Head Neck Surg. 2019;71(1):81-85. doi:10.1007/s12070-018-1481-6U.S. National Library of Medicine: MedlinePlus.Electromyography.Hamdan AL, Khalifee E, Berjawi G.Unilateral cricoarytenoid joint ankylosis in rheumatoid arthritis.Ear Nose Throat J. 2020;99(1):11-12. doi:10.1177/0145561319825734Eddaoudi M, Rostom S, Amine B, Bahiri R.The involvement of vocal cords in rheumatoid arthritis: A clinical case.Pan Afr Med J. 2019;34:102. Published 2019 Oct 21. doi:10.11604/pamj.2019.34.102.20490Iacovou E, Vlastarakos PV, Nikolopoulos TP.Laryngeal involvement in connective tissue disorders. Is it important for patient management?Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):22-29. doi:10.1007/s12070-012-0491-zYılmaz T, Altuntaş OM, Süslü N, et al.Total and partial laser arytenoidectomy for bilateral vocal fold paralysis.Biomed Res Int. 2016;2016:3601612. doi:10.1155/2016/3601612
Pradhan P, Bhardwaj A, Venkatachalam VP.Bilateral cricoarytenoid arthritis: a cause of recurrent upper airway obstruction in rheumatoid arthritis.Malays J Med Sci. 2016;23(3):89-91.
Izuka S, Kaneko S, Harada T, et al.Cricoarytenoid arthritis in rheumatoid arthritis. Rheumatology. 2021;60(8):3955-3955. doi: 10.1093/rheumatology/keaa838
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Stridor.
Ohio State University Wexner Medical Center: PathologyOutlines.com.Bone & joints: Arthritis, rheumatoid arthritis.
Farah C, Tabesh OA, Okais J, Hajjar A, Haddad A.Cricoarytenoid joint arthritis: A possible complication of dermatomyositis.Pan Afr Med J. 2020;36:74. Published 2020 Jun 9. doi:10.11604/pamj.2020.36.74.18891
National Institutes of Health, U.S. National Library of Medicine: MedlinePlus.Autoimmune disorders.
Abdel Razek AA.Imaging of connective tissue diseases of the head and neck.Neuroradiol J. 2016;29(3):222–30. doi:10.1177/1971400916639605
U.S. National Library of Medicine: MedlinePlus.Laryngoscopy and nasolaryngoscopy.
Joshi AA, Velecharla MS, Patel TS, Shah KD, Bradoo RA.Management of difficult laryngeal exposure during suspension microlaryngoscopy.Indian J Otolaryngol Head Neck Surg. 2019;71(1):81-85. doi:10.1007/s12070-018-1481-6
U.S. National Library of Medicine: MedlinePlus.Electromyography.
Hamdan AL, Khalifee E, Berjawi G.Unilateral cricoarytenoid joint ankylosis in rheumatoid arthritis.Ear Nose Throat J. 2020;99(1):11-12. doi:10.1177/0145561319825734
Eddaoudi M, Rostom S, Amine B, Bahiri R.The involvement of vocal cords in rheumatoid arthritis: A clinical case.Pan Afr Med J. 2019;34:102. Published 2019 Oct 21. doi:10.11604/pamj.2019.34.102.20490
Iacovou E, Vlastarakos PV, Nikolopoulos TP.Laryngeal involvement in connective tissue disorders. Is it important for patient management?Indian J Otolaryngol Head Neck Surg. 2014;66(Suppl 1):22-29. doi:10.1007/s12070-012-0491-z
Yılmaz T, Altuntaş OM, Süslü N, et al.Total and partial laser arytenoidectomy for bilateral vocal fold paralysis.Biomed Res Int. 2016;2016:3601612. doi:10.1155/2016/3601612
Maini RN, Venables PJW.Patient information: Rheumatoid arthritis symptoms and diagnosis.
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