Most people think rheumatoid arthritis affects only the small joints of the hands of feet. However, any joints in the body that contain cartilage and synovial fluid are targets for the disease.
Small joints in the voice box can be affected by arthritis. The larynx, or voice box, actually contains joints, called cricoarytenoid joints, that move the vocal cords to produce sound. If these joints become inflamed, which causes pain, then the vocal cords are not in the correct position to produce clear sound. As with other joints affected by rheumatoid arthritis, joint erosions and rheumatoid nodules also can be found, which may cause further damage. If these joints are affected to the point that they become fixed in place unable to move, there can be difficulty breathing. This constitutes a medical emergency.
About 25% of rheumatoid arthritis patients experience the symptoms above, plus a sense 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 sound conduction. These bones, called ossicles, also have joints. When rheumatoid arthritis inflames or erodes those joints, they become less mobile.
Rheumatoid arthritis patients who have larynx or ear involvement 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 scopes to examine the throat and ears to make a correct diagnosis. If you have any of these symptoms and are bewildered by them, get to your doctor quickly.