Patient Basics: Polychondritis

Polychondritis, usually called relapsing polychondritis, is a rare autoimmune disease. The immune system turns on cartilage, the firm, bendable tissue that shapes the ears and nose and lines the joints and windpipe. It causes painful, red, swollen flares that come and go. The outer ear is the part most often affected. Polychondritis can also involve the eyes, inner ear, airway and heart, so early diagnosis and regular checks are important.

Key points

• It usually starts between ages 40 and 60 and affects men and women about equally.
• The classic sign is a sudden red, painful, swollen outer ear that spares the earlobe.
• No single blood test confirms it. Diagnosis is based on the pattern of symptoms, sometimes with a biopsy or scans.
• Steroids calm flares, and other medicines help keep the disease quiet.
• Hoarseness, noisy breathing or shortness of breath can mean the airway is involved and need prompt care.

What causes polychondritis

The cause is unknown. The immune system makes antibodies and immune cells that target proteins found in cartilage and in some other tissues, such as the eye and heart valves. Genes may make some people more likely to get it.

About 1 in 3 people with polychondritis also has another condition, such as rheumatoid arthritis, lupus, an inflammation of blood vessels (vasculitis), or a bone marrow disorder. In older men, a condition called VEXAS syndrome, caused by a gene change that develops in blood cells during life, can look like polychondritis. It also brings fevers and low blood counts.

Symptoms of polychondritis

Symptoms appear in flares that last days to weeks and then settle. Repeated flares can damage cartilage for good.

• Ears. One or both outer ears suddenly turn red or purple, swollen, warm and very tender. The earlobe, which has no cartilage, stays normal. Over time the ear can become soft or floppy.
• Nose. Pain and redness over the bridge of the nose. Damage can make the bridge sink (saddle nose).
• Joints. Pain and swelling in large or small joints, and pain where the ribs meet the breastbone.
• Eyes. Red, painful or light-sensitive eyes from inflammation of the white of the eye or inside the eye.
• Inner ear. Hearing loss, ringing in the ears, dizziness or a spinning feeling.
• Airway. Hoarseness, a sore throat over the voice box, cough, wheezing or shortness of breath. The windpipe can narrow or become floppy.
• Heart and blood vessels. Leaky heart valves or inflammation of the aorta, the body’s main artery.
• Whole body. Fever, tiredness, weight loss and skin rashes.

How polychondritis is diagnosed

A rheumatologist usually makes the diagnosis based on typical symptoms, such as inflammation of both ears, the nose or the airway. An ear infection or injury can look similar, so your doctor will rule those out first. Tests may include:

• Blood tests for inflammation (ESR and CRP), blood counts, and kidney and liver tests
• A small biopsy of ear cartilage, if the diagnosis is unclear
• Breathing tests and a CT scan of the chest to check the windpipe and airways
• An echocardiogram (heart ultrasound) to check the heart valves and aorta
• Hearing and eye exams
• A PET-CT scan, which can show inflamed cartilage throughout the body
• A genetic blood test for VEXAS syndrome in some older men

Polychondritis treatment

Treatment depends on where the inflammation is and how severe it is.

• Mild flares of the ears, nose or joints may respond to anti-inflammatory pain relievers (NSAIDs), colchicine or dapsone.
• Corticosteroids such as prednisone are the main treatment for most flares. Higher doses, sometimes through a vein, are used when the eyes, airway, heart or inner ear are involved.
• Steroid-sparing medicines, such as methotrexate, azathioprine or mycophenolate, help control the disease so you can take less prednisone.
• Biologic medicines, such as infliximab, adalimumab or tocilizumab, may help when other treatments don’t.
• Airway care. A narrowed windpipe may need a stent, a breathing machine at night, or surgery.
• Other care. Hearing aids, eye treatment from an eye doctor, and bone protection while on steroids.

Living with polychondritis

The course differs from person to person. Some people have occasional mild flares, while others need ongoing treatment. Regular visits help catch airway, heart, eye and hearing problems early, even when you feel well. Don’t smoke, keep vaccines up to date, and tell any surgeon or anesthesia team about your airway before a procedure.

When to see a doctor

See a doctor for a red, swollen, painful ear without an obvious cause, especially if it comes back, or for a painful red eye. Get emergency care for trouble breathing, noisy or high-pitched breathing, sudden hearing or vision loss, chest pain, or fainting.

Common questions about polychondritis

What does polychondritis of the ear look like?

The outer ear turns bright red or purple, swells and feels hot and very tender, often on both sides. The earlobe looks normal because it has no cartilage, which helps tell polychondritis apart from an infection. After many flares, the ear may look lumpy or droopy.

Is relapsing polychondritis serious?

It can be. Ear and nose flares are painful but not dangerous. Inflammation of the windpipe, heart valves or aorta can be life-threatening if untreated. With early diagnosis, the right medicines and regular checks, many people keep the disease under control.

Is polychondritis hereditary?

No, it isn’t passed down in families in a clear way, and it isn’t contagious. Genes may make some people more likely to get it. VEXAS syndrome, which can look like polychondritis, comes from a gene change that develops in blood cells during life and isn’t inherited.

Questions to ask your doctor

• Where in my body is the inflammation?
• Do I need tests of my airway, heart, eyes or hearing?
• Which medicines do you suggest, and what are the side effects?
• What signs of a flare should I watch for?
• Should I be tested for VEXAS syndrome or a related condition?

Learn more

• Relapsing polychondritis (DermNet)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.