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How can you tell the difference between arthritis and polychondritis?

Q) Many years ago I was diagnosed with polychondritis, which affected my eye, nose and throat. I was on cortisone for several months and was told that if there was a relapse I should take it again. I understand that the joints and heart can also be affected, and as I have had very painful knees for some time I wonder how one can tell which is arthritis and which is chondritis?
E Worsley, Lytham St Anne’s, Lancashire

A) Relapsing polychondritis is a rare condition in which tissues containing cartilage become inflamed. As you point out, the cartilage of the ear, nose and windpipe are most commonly affected, but cartilage elsewhere, in the heart valves and joints, may be involved. Treatment is with steroids and other immunosuppressive drugs, as the condition is essentially an autoimmune disorder. An autoimmune disorder occurs where the immune system attacks normal tissue, in this case cartilage.

Many arthritic conditions are autoimmune disorders, rheumatoid arthritis and lupus included, and inflammation in collagen containing tissues (cartilage is mainly collagen, but other tissues, such as blood vessels and heart valves, can contain collagen) can occur in these conditions as well. Joint inflammation can therefore occur in polychondritis.

The knee pain you experience may be due to another cause, such as osteoarthritis, but it would be best to see a rheumatologist to let them decide, as a relapse in polychondritis should, as you say, be treated.

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