How do you approach confirming a diagnosis of limited GPA with nasal involvement vs relapsing polychondritis?  

Patient with progressive saddle-nose deformity and +PR3 antibodies is otherwise asymptomatic. Nasal biopsy showed nonspecific inflammation without granulomas, and CT of the chest and sinuses is unremarkable. No history of cocaine use.

Given these findings, would you diagnose limited GPA and initiate treatment with methotrexate or rituximab, or is further evaluation needed? Would nasal reconstruction with cartilage or bone be a viable option?