Author(s): Henrique Furlan Pauna and Rafael da Costa Monsanto
Ear-nose-throat (ENT) manifestations of connective tissue disorders can be the first manifestation of these disorders and represent a diagnostic challenge for clinicians as they often constitute the initial sign of an otherwise asymptomatic autoimmune disease. Rheumatic diseases have high taxes spread worldwide and the otolaryngological manifestations (auditory, nasal, laryngeal) of this represent a great challenge not only to the generalist physician but also to the ENT doctor and rheumatologist. The irreversible destruction of the cartilage, tendon, and bone that comprise synovial joints is the hallmark of both rheumatoid arthritis (RA), affecting approximately 1% of human population, and osteoarthritis (OA). The effector mechanism, which initially attacks small joints, is T-cell driven. As a result, an aggressive synovial pannus develops, which destroys articular cartilage and bone, leading to massive ankylosis and deformities of peripheral joints. While cartilage is made up of proteoglycans and type II collagen, tendon and bone are composed primarily of type I collagen. RA is a progressive and autoimmune disease afflicting numerous joints throughout the body.
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