chronic postrheumatic arthropathy (Jaccoud's arthropathy)
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Etiology
- systemic lupus erythematosus (most common)[4]
- 1st described in patients with rheumatic fever[4]
- other diffuse connective tissue disease
Epidemiology
- 5% of patients with systemic lupus erythematosus[4]
Pathology
- persistent periarticular inflammation affecting structural integrity of joint capsule & supporting ligaments[4]
- laxity of ligaments, fibrosis of the capsule, & muscular imbalance, rather than from destruction of the bone of joints[3]
Clinical manifestations
- joint deformities are primarily in the hands
- reducible subluxation of the digits[4]
- muscle atrophy
- severe ulnar deviation & flexion at the metacarpal-phalangeal joints
- swan neck deformity[3][4]
- Z deformity of the thumb[3] (case report)
- resembles rheumatoid arthritis, but with less inflammation
Laboratory
- rheumatoid factor is negative
- anti-CCP Ab is negative[3] (case report)
Radiology
- radiographs shows no erosions[4]
- MRI of hand shows no erosions[3] (case report)
Management
- physical therapy & the use of orthotic devices[3]
- poorly responsive to DMARDS[3]
- response to biologic response modifiers is unknown
- soft-tissue surgery for the correction of the hand deformities[3]
More general terms
References
- ↑ Grahame R et al Chronic post-rheumatic fever (Jaccoud's) arthropathy. Ann Rheum Dis. 1970 November; 29(6): 622-625. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1010593/
- ↑ Emrich L Chronic Post-Rheumatic Polyarthrosis: What is Jaccoud's Arthropathy? http://www.healthcentral.com/rheumatoid-arthritis/c/72218/138460/post
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Santiago M, Machicado V Jaccoud's arthropathy. (image, video) N Engl J Med 2015; 373:e1. July 2, 2015 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26132963 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1410743
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 Skare TL, Godoi Ade L, Ferreira VO. Jaccoud arthropathy in systemic lupus erythematosus: clinical and serological findings. Rev Assoc Med Bras. 2012 Jul-Aug;58(4):489-92 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22930030