当风湿性关节炎的症状讨论中，我们经常谈论疼痛，僵硬，肿胀和残疾。我们不经常谈论的音质或自由呼吸的能力，但RA可以影响喉和头部和颈部的小关节，包括颞下颌关节（TMJ），在环杓关节（CAJ）和环甲关节（CTJ）。
根据new literature review in the journalAutoimmune Diseases, the prevalence of laryngeal symptoms of RA has risen在过去的几十年。至少这显著上升的部分可能是由于认识的提高和更好的临床诊断。
Symptoms of larynx involvement caused by RA include odynophagia (painful swallowing), foreign body sensation, dysphagia (difficulty swallowing), sore throat, lump sensation in the throat, change in voice quality (e.g. hoarseness, breathiness, vocal fatigue), referred otalgia (earache), and respiratory symptoms (e.g. shortness of breath, decreased exercise tolerance, stridor, dyspnea, respiratory distress). In rare cases, patients with RA may also present with symptoms of croup. Patients may also be asymptomatic.
Dysphonia, or change in voice quality, may be the most noticeable symptom caused by changes in the larynx caused by RA. The change in voice quality may vary from mild roughness to complete aphonia (inability to produce a sound). Based on the GRBAS scale - where G stands for grading, R for roughness, B for breathiness, A for asthenia, and S for straining - 35% of patients with RA have grades 2 and 3 (Amernik, 2007).
In a study of 77 patients with RA with average disease duration of 9.4 years, the most frequent complaints were foreign body sensation in 51%, hoarseness in 47%, and voice weakness in 29% of the cases (Amernik, 2007). In acute phases, patients may complain of burning, foreign body sensation in the throat, and difficulty in swallowing. In chronic cases, the cricoarytenoid joint (CAJ) can become fixed and airway symptoms that arise may require an emergency tracheotomy.
当炎症是温和的，只有一个喉联合参与（CAJ或CTJ），患者可能出现气道最小的症状，偶尔或轻度持续性呼吸道不适，气短，和运动耐受力降低。如果两个声带是不动的，患者可能出现breathiness，声带疲劳，无力维持或发出声音。如果声带固定在中线，关节炎可能危及与呼吸困难（吞咽困难）和窒息患者。
检查用内窥镜，以查看喉可以揭示炎症，粘膜水肿，充血（充血），肌炎，受损迁移率或声带的固定，会厌，风湿性结节，或竹节点的炎症。然而，在疾病的早期阶段，喉癌的检查可能是正常的。
炎性肿块或类风湿结节在喉和咽类似于类风湿结节可在身体其他部位的发育。结节可以是粘膜下和/或皮下肿块。结节的诊断可以通过切除病灶或进行细针穿刺来完成。竹节点是其在声带横向布置的囊性黄色的沉淀物。这些病变在活动性疾病患者，女性与胃食管反流病（GERD）的历史多见。
肌电图(EMG)是一个有用的测试区域uish between CAJ fixation and paralysis secondary to recurrent laryngeal nerve injury. High-resolution CT (computerized tomography) scan can detect CAJ arthritis in the early stages. Scans may reveal CAJ prominence, increased density of the joint, narrowing of the joint space, ankylosis, and vocal fold thickening.
对RA的喉表现的药物治疗包括使用类固醇或非类固醇抗炎药（NSAID），以避免形成结节或纤维化。类固醇可以全身或局部给予注入关节。竹节点可以手术切除。保守治疗可以用言语治疗开始。如果后言语治疗的患者仍然有声乐质量，激素注射和手术治疗的变化麻烦可能会建议。当两个声带固定在中线，可能需要气管切开术（临时或永久），以减轻气道阻塞。
作为RA可以影响身体的许多领域，包括喉部的生物力学，为RA病人和医生需要注意的微妙呼吸道症状和/或语音质量变化的意义是很重要的。如果你的声音也变得嘶哑，你觉得你有你的喉咙的东西，或者你的呼吸变得强调，告诉你的医生。早期诊断，合理治疗，喉表现的康复可以减轻痛苦，提高安全性的RA患者。
资料来源：
Amernik K. Glottis morphology and perceptive-acoustic characteristics of voice and speech in patients with rheumatoid arthritis.年鉴Academiae Medicae Stetinensis2007;53(3):55-65.
哈姆丹AL，类风湿关节炎Sarieddine D.喉表现。Autoimmune Diseases2013; vol. 2013, Article ID 103081, 6 pages.
doi:10.1155/2013/103081
Kamanli A，斛，U。，等人。双侧环杓关节受累于风湿性关节炎：病例报告。Rheumatology2001;40:593-594. doi:10.1093/rheumatology/40.5.593
Lawry GV，Finerman ML，Hanafee WM。喉参与类风湿性关节炎的临床，喉镜和计算机断层扫描研究。Arthritis and Rheumatism1984;27(8):873-882.