Most people think that rheumatoid arthritis affects only the small joints in the hands or feet. However, any joint in the body that contains cartilage and synovial fluid is a target of the disease.
The small joints of the larynx can be affected by arthritis. The larynx, or larynx, actually contains joints, called cricoarytenoids, that move the vocal cords to produce sound. If these joints become inflamed, causing pain, the vocal cords are not in the correct position to produce a clear sound. As with other joints affected by rheumatoid arthritis, joint erosions and rheumatoid nodules may also be found, which can cause further damage. If these joints are affected to the point of being fixed in one place and unable to move, there may be difficulty in breathing. This constitutes a medical emergency.
About 25% of rheumatoid arthritis patients experience the above symptoms, plus a feeling of fullness in the throat when swallowing or speaking, as well as occasional pain in the ears. There are small bones in the ear that are responsible for the conduction of sound. These bones, called ossicles, also have joints. When rheumatoid arthritis inflames or erodes those joints, they become less mobile.
Patients with rheumatoid arthritis who have involvement of the larynx or ear as described above should have an ear, nose, and throat specialist involved in their care, along with a rheumatologist. Ear, nose, and throat specialists have special endoscopes to examine the throat and ears to make a correct diagnosis. If you have any of these symptoms and are puzzled by them, see your doctor quickly.