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Relapsing Polychondritis

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This is a patient who had incidental findings associated

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with the pinna of the ear and the external auditory canal.

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As we scroll in the soft tissue window, you notice that

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there are calcifications associated with the

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cartilage of the ear bilaterally, including

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the cartilaginous portion of the external auditory canal.

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And this is occurring on the right

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side as well as the left side.

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And it's pretty dramatic calcification.

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If we look at it on bone window,

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on coronal imaging, you see what looks like a bone

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of the pinna of the ear, which is very unusual.

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And you can see, though, in the walls of the external canal,

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cartilaginous portion, calcification as well as extending

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here towards the temporomandibular joint.

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So what is in our differential diagnosis for

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calcifications of the external auditory

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canal and the external ear?

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The differential diagnosis includes

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some metabolic disorders including hyperparathyroidism.

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So if you have a calcium-phosphorus dysmetabolism syndrome,

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you could have calcification being deposited in

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the soft tissues of the cartilage of the ear.

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Additionally, we think about calcium

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pyrophosphate deposition disease,

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CPPD, and that is potentially another term that we

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sometimes use as pseudogout, and that may also cause

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calcification associated with cartilage

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in these soft tissues.

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Gout itself is another cause of dystrophic calcification

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in soft tissues, and the other things would be things

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related to trauma with dystrophic calcification,

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frostbite with dystrophic calcification,

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and sarcoidosis, which could also

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have calcification in the soft tissues.

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In this particular case, this was actually an inflammatory

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disorder called relapsing polychondritis that the patient

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was known to have and had these episodes of discomfort

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in the external ear and external

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auditory canal bilaterally.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Trauma

Temporal bone

Non-infectious Inflammatory

Neuroradiology

Metabolic

Idiopathic

Head and Neck

CT

Brain

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