Laryngeal Arthritis: Symptoms, Associated Conditions, and When to Seek Help

What are the symptoms of arthritis in the throat?

Arthritis affecting the throat, typically referring to inflammation of the laryngeal joints (most commonly the cricoarytenoid joints), can manifest as hoarseness, difficulty swallowing, throat pain, a sensation of a lump in the throat, and in severe cases, breathing difficulties. These symptoms are often a localized manifestation of a broader systemic inflammatory condition.

Understanding Arthritis of the Laryngeal Joints

When we discuss "arthritis in the throat," we are primarily referring to inflammation of the small, critical joints within the larynx, or voice box. The most commonly affected are the cricoarytenoid joints. These paired synovial joints are crucial for the movement of the arytenoid cartilages, which in turn control the tension and position of the vocal cords. Their proper function is essential for voice production, swallowing, and breathing.

Unlike common osteoarthritis which typically affects larger weight-bearing joints, arthritis in the larynx is almost always a manifestation of a systemic inflammatory arthritic condition. It is not usually a standalone or primary diagnosis. Understanding this distinction is vital for accurate diagnosis and management.

Primary Symptoms of Laryngeal Arthritis

The symptoms of arthritis affecting the laryngeal joints can vary in intensity and may develop gradually. Recognizing these signs is crucial for prompt medical evaluation.

• Voice Changes (Dysphonia): This is often one of the earliest and most noticeable symptoms.
  • Hoarseness: A rough, breathy, or strained voice quality.
  • Vocal Fatigue: The voice tires easily, especially after prolonged speaking.
  • Loss of Vocal Range: Difficulty hitting high or low notes, or reduced vocal projection.
  • Aphonia: In severe cases, a complete loss of voice.
• Throat Discomfort and Pain:
  • Throat Pain: Localized pain in the front of the neck or a sensation of soreness in the throat, often worsened by speaking, swallowing, or turning the head.
  • Sensation of a Lump (Globus Sensation): A persistent feeling of something stuck in the throat, even when nothing is there.
  • Tightness or Swelling: A subjective feeling of constriction or swelling in the throat area.
• Swallowing Difficulties (Dysphagia):
  • Painful Swallowing (Odynophagia): Sharp or burning pain when food or liquids pass through the throat.
  • Difficulty Initiating Swallowing: Hesitation or effort required to start the swallowing process.
  • Choking or Coughing: Especially when eating or drinking, due to impaired vocal cord closure.
• Breathing Issues (Dyspnea):
  • Stridor: A high-pitched, noisy breathing sound, particularly on inhalation, indicating significant airway narrowing. This is a serious symptom requiring immediate medical attention.
  • Shortness of Breath: Feeling breathless, especially during exertion, if the airway is compromised.
• Referred Pain: Pain that radiates to the ears, neck, or jaw.
• Systemic Symptoms: Because laryngeal arthritis is typically part of a broader condition, individuals may also experience symptoms related to their underlying systemic disease, such as:
  • Joint pain, stiffness, and swelling in other parts of the body (e.g., hands, wrists, knees).
  • Fatigue.
  • Fever.
  • General malaise.

Associated Systemic Conditions

Laryngeal arthritis is most commonly observed in individuals diagnosed with the following inflammatory autoimmune conditions:

• Rheumatoid Arthritis (RA): This is the most frequent cause, affecting the cricoarytenoid joints in a significant percentage of RA patients, though often subclinically.
• Ankylosing Spondylitis (AS): A chronic inflammatory disease primarily affecting the spine, but can involve other joints, including those of the larynx.
• Psoriatic Arthritis (PsA): An inflammatory arthritis that occurs in people with psoriasis.
• Gout: While less common in the larynx, severe gout can affect any joint.
• Systemic Lupus Erythematosus (SLE): An autoimmune disease that can affect various body systems, including joints.
• Relapsing Polychondritis: A rare autoimmune disorder characterized by recurrent inflammation of cartilage throughout the body, including the larynx and trachea.

When to Seek Medical Attention

It is imperative to consult a healthcare professional if you experience any persistent or concerning throat symptoms, especially if you have a known diagnosis of an inflammatory arthritic condition. Prompt medical attention is warranted for:

• Any new or worsening hoarseness or voice changes that last more than two weeks.
• Persistent throat pain without an obvious cause (like a cold or infection).
• Difficulty or pain with swallowing.
• Any sensation of a lump in your throat that doesn't resolve.
• Any difficulty breathing or noisy breathing (stridor).

Importance of Diagnosis and Management

Diagnosing laryngeal arthritis typically involves a thorough medical history, physical examination, and potentially a laryngoscopy (a procedure where a thin, flexible tube with a camera is inserted through the nose or mouth to visualize the larynx). Imaging studies (such as CT scans or MRI) and blood tests (to check for markers of inflammation or specific autoimmune antibodies) may also be used to confirm the diagnosis and identify the underlying systemic condition.

Management is primarily focused on treating the underlying systemic inflammatory disease with medications prescribed by a rheumatologist, such as disease-modifying antirheumatic drugs (DMARDs), biologics, or corticosteroids. Voice therapy, vocal rest, hydration, and avoiding throat irritants can also be part of a supportive management plan. Early diagnosis and appropriate medical intervention are crucial to alleviate symptoms, prevent permanent damage to the laryngeal joints, and avoid potential airway compromise.