What Baseline Tests Are Recommended After RP Diagnosis?

When you are diagnosed with relapsing polychondritis (RP), your rheumatologist or multidisciplinary care team will likely recommend a baseline medical evaluation. Because RP can affect cartilage and connective tissue throughout the body—including the airways, heart, and blood vessels—disease activity can sometimes occur in these critical areas before you notice symptoms ^[1][2].

However, there is no single blood test that confirms RP, and there is no universally mandated “one-size-fits-all” panel of tests. Your baseline testing plan will be individualized based on your specific symptoms, physical examination, age, and medical history. A comprehensive evaluation helps identify any hidden inflammation early and provides a snapshot of your organ function to compare against in the future ^[3].

When to Seek Urgent Care
While baseline testing is important for understanding your overall health, it is meant for stable evaluation. Do not wait for a scheduled scan or baseline test if you experience any of the following:

• New or rapidly worsening shortness of breath
• Noisy breathing (stridor) or an inability to lie flat
• Sudden chest, back, or abdominal pain
• Sudden vision loss, severe eye pain, or sudden hearing loss
  Seek emergency medical care immediately for these symptoms.

Airway and Lung Assessment

Because airway involvement is a known complication of RP, your team may consider assessing your respiratory tract even if you feel you are breathing normally. In one study of 173 RP patients, 66% of those without breathing symptoms showed some radiographic airway abnormalities on imaging ^[4]. Common baseline assessments include:

• Pulmonary Function Tests (PFTs): These breathing tests measure lung capacity and airflow. They often include a flow-volume loop, which helps identify if the central airways are narrowed ^[5][6].
• Dynamic Chest CT Scan: If considered appropriate by your doctor, this specialized CT scan covers the chest and neck (cervical trachea). Images are taken during inhalation and forced exhalation to see if the airways collapse during breathing ^[1][5]. Your doctor will weigh the diagnostic benefits of this test against the exposure to radiation and contrast dye.

Bronchoscopy (a procedure where a flexible camera is inserted into the airways) is generally avoided for routine screening in RP because it can irritate fragile cartilage and provoke airway spasms; it is usually reserved for specific situations where specialists need direct airway inspection or to perform an intervention ^[1][7].

Cardiovascular Screening

RP can affect the heart valves, heart muscle, and the aorta (the body’s main artery) ^[8]. Because early cardiovascular changes often do not cause symptoms, your doctor may consider:

• Electrocardiogram (ECG) and Echocardiogram: An ECG checks the heart’s electrical rhythm, while an echocardiogram (an ultrasound of the heart) evaluates the heart muscle and ensures the valves are functioning properly ^[9].
• Aortic Imaging: A specialized CT angiography (CTA) or magnetic resonance angiography (MRA) may be ordered to check the aorta for inflammation or widening (aneurysm) ^[10][11]. In a review of 114 RP patients with known aortic involvement, 19% had no symptoms when the aortic issue was discovered ^[2]. Your rheumatologist or cardiologist will decide if this imaging is necessary for you based on your personal risk factors.

Blood Tests and VEXAS Syndrome

Routine baseline blood work often includes a complete blood count (CBC), kidney and liver function panels, and inflammatory markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). It is important to know that having normal CRP or ESR levels does not guarantee the absence of RP activity; these labs are just one piece of the clinical puzzle ^[12][13].

The VEXAS Evaluation
Your doctor will review your CBC for clues of VEXAS syndrome, a condition that can closely mimic RP. Unlike inherited genetic diseases, VEXAS is caused by an acquired mutation in the UBA1 gene within blood-forming cells, meaning it is not passed down to your children ^[14]. Testing for VEXAS is typically considered for patients—most commonly men whose symptoms began after age 45, though it rarely occurs in women—who have treatment-resistant inflammation combined with specific blood abnormalities like macrocytosis (unusually large red blood cells) or low platelets ^[15][16].

Vision and Hearing Examinations

Because RP frequently causes inflammation in the cartilage of the ears and the connective tissue of the eyes, baseline evaluations by an ophthalmologist (eye specialist) or audiologist (hearing specialist) are often considered ^[17]. These exams are especially important if you have symptoms like eye redness, pain, light sensitivity, ringing in the ears, or balance issues ^[18][19], but they can also establish a helpful baseline for future comparison if new symptoms arise.