September 2026 Research Update

This month, studies looking at imaging in relapsing polychondritis (RP) added a clearer picture of what scans can and cannot tell you. One set of results suggests CT scans may help distinguish RP airway disease from a similar condition that can also narrow the airways, while a review of PET/CT suggests many people with RP show scan evidence of active inflammation, sometimes even where symptoms are not obvious. Together, these studies point to imaging as a way to map where disease is active and what kind of airway damage is present, but they also show that predicting longer-term airway outcomes remains uncertain. [1] [2]

In a comparison of people with airway involvement, RP more often affected the central airway areas like the subglottic region and cervical trachea, and CT more often showed structural changes such as airway wall thickening, narrowing, and calcification. By contrast, the comparison group with ANCA-associated vasculitis more often had disease in smaller, more distant bronchi and more frequent lung tissue involvement. For patients, this helps explain why doctors may use CT patterns to sort out what is driving breathing problems when different diseases can look similar at first. [1]

Across three small studies in a meta-analysis, PET/CT was positive in most people evaluated for RP, and the scan sometimes identified cartilage involvement that was not causing symptoms. PET findings also moved in the same direction as blood markers of inflammation in the included studies, suggesting PET may reflect inflammatory activity rather than only permanent damage. This matters because it supports the idea that PET/CT can help show the spread of inflammation in the body, although the review noted that larger prospective studies are still needed to define its diagnostic accuracy and its ability to predict future course. [2]

The airway comparison study also reported different experiences after tracheostomy: decannulation was achieved less often in RP than in the comparison condition after medical treatment. Because this was a retrospective comparison with relatively small numbers, it cannot explain why outcomes differed, but it underscores that airway narrowing in RP may involve structural injury that can be hard to reverse. For patients and caregivers, this provides context for why airway involvement in RP can be complex and why imaging findings about airway structure may matter when discussing expected recovery. [1]

For patients, the main practical message this month is that imaging is being used to answer two different questions: where inflammation is active, and where airway structure has been changed. CT patterns may help separate RP-related airway disease from other causes of airway narrowing, and PET/CT may pick up cartilage inflammation even when symptoms are quiet, which could matter for understanding the full body involvement. This does not establish a single best scan or prove that scan results predict a person’s future, but it strengthens the idea that different scans give different kinds of information that may matter now for evaluation and later if research confirms prognostic value. What remains uncertain is how often PET/CT changes outcomes and how reliably any scan can forecast airway recovery in RP. [1] [2]