Chondritis

Chondritis is an inflammation of cartilaginous tissue. As cartilage is inherently avascular and lacks its own blood supply, the inflammatory process tends to localize in the perichondrium — the connective tissue layer that nourishes the cartilage.

The primary risk of chondritis is that inflammation and edema within the perichondrium disrupt the nutrient supply to the cartilage. This can rapidly lead to necrosis and liquefaction of the cartilage, resulting in irreversible structural deformation.

Etiology and pathophysiology

Cartilage inflammation may be associated with:

• Infection. This is the most common etiology. Bacteria, most frequently Pseudomonas aeruginosa or Staphylococcus aureus, may infiltrate the tissue following trauma, ear piercing, surgical intervention, or spread from adjacent infectious foci.
• Autoimmune diseases. Systemic diseases in which the immune system targets the body’s own cartilage. A classic example is relapsing polychondritis.
• Trauma. Direct injury to the cartilage or perichondrium can initiate an aseptic (noninfectious) inflammatory response.

Pathophysiologically, inflammation of the perichondrium leads to swelling and detachment from the underlying cartilage. This separation impairs nutrient diffusion, causing ischemia and necrosis of the cartilaginous plate.

Clinical Significance

The most common clinical form is auricular chondritis. It presents with severe pain, swelling, erythema, and increased temperature of the entire auricle — except for the earlobe, which lacks cartilage. As the condition progresses, an abscess may form.

Diagnosis is based on clinical manifestations. To preserve cartilage integrity, treatment strategy should be aggressive. It typically includes systemic antibiotic therapy with agents targeting Pseudomonas aeruginosa, and — if an abscess develops — surgical incision, drainage, and debridement of necrotic tissue.

Chondritis may also affect the cartilages of the larynx (causing dyspnea and voice changes) or the costal cartilages, as seen in Tietze syndrome.