Pustulotic arthro‐osteitis (PAO) is a major complication of palmoplantar pustulosis (PPP). In orthopedic surgery outpatient clinics, PPP patients with osteoarticular symptoms are seen frequently, but PAO's clinical features remain not well known. To determine Japanese patients’ clinical features and treatment status with PAO, we conducted a single‐center retrospective epidemiologic survey. Clinical features, including gender, age, smoking habit, the onset pattern, interval between skin manifestation and osteoarticular symptoms, and the incidence of sternoclavicular joint lesions, axial and peripheral joint lesions, were examined. The association between physical status and image findings by X‐ray, computed tomography, bone scintigraphy with Technetium99, or magnetic resonance imaging was evaluated. The distribution pattern of peripheral joint lesions and the treatment status were evaluated. We identified 51 patients, 10 men and 41 women, with PAO. The average age was 48 years and 59% were smokers. The frequency of onset patterns was skin‐leading type (63%), simultaneous onset (18%), and osteoarticular leading type (16%). The average interval between skin involvement and osteoarticular involvement in skin‐leading type was significantly longer than that in osteoarticular leading type (7.1 years vs. 2.0 years). A sternoclavicular joint (SCJ) lesion was detected in 65% cases, and the physical findings of SCJ were significantly related to the image findings. Axial and peripheral joint lesions were detected in the same ratio (23 cases, 45%). In the peripheral joints, the finger joint was the most common (26%), followed by the shoulder joint (21%). Patients were treated with nonsteroidal anti‐inflammatory drugs (76%), followed by conventional synthetic disease‐modifying antirheumatic drugs (DMARDs) (29%) and biological DMARDs (9.8%). Tonsillectomy was performed in 11 cases. In conclusion, PAO more frequently involves SCJ in middle‐aged women who smoke. Given that osteoarticular leading type was detected in 16% cases, seronegative oligoarthritis patients should be monitored for PPP, leading to a diagnosis of PAO.

Objectives To investigate the outcomes of the modified Thompson–Littler (m-TL) method, a corrective surgical method utilising a dynamic tenodesis, in patients with rheumatoid swan-neck deformity. Methods Twenty-seven fingers in 10 patients with rheumatoid arthritis (RA) underwent surgical correction. The mean age at the time of surgery was 60.3 (45–77) years, the mean duration of RA was 19.3 (4–34) years, and the mean postoperative follow-up period was 2.4 (0.5–6) years. Results The deformity was corrected and the proximal interphalangeal (PIP) joint pain disappeared in all operated fingers. The mean pinch power between the thumb and the operated finger increased. The active extension decreased, the active flexion increased, and the total arc of motion decreased. Comparing the range of motion by Nalebuff’s type classification, the postoperative arc of motion decreased as the type advanced. Conclusions The m-TL method provided a favourable outcome in cases of Type ≤III rheumatoid swan-neck deformity without severe joint deterioration at the PIP joint. Aesthetic and functional improvements were observed and the patients were satisfied with the operation.

Psoriatic arthritis (PsA) is a complex musculoskeletal disorder. Its clinical features include psoriasis, peripheral arthritis, spinal involvement, enthesitis, and dactylitis. Typically, skin lesions precede osteoarticular lesions, although osteoarticular lesions can precede skin lesions in some cases. This study aimed to investigate the onset pattern of PsA, the time interval between the occurrence of skin and osteoarticular lesions, and the treatment status of PsA. A total of 64 patients with PsA who had been assessed according to the CASPAR criteria were enrolled. Of those, 75% had a typical lesion onset pattern where skin lesions preceded osteoarticular lesions (skin leading) and 16% had an osteoarticular leading lesion pattern. The mean time interval between the onset of lesions in patients with the skin leading pattern was 14.2 years and that in patients with the osteoarticular leading pattern was 4.5 years. Non-steroidal anti-inflammatory drugs were prescribed to 39% of patients, conventional synthetic disease modifying antirheumatic drugs (DMARDs) to 64%, and biologic DMARDs to 51.5%. In conclusion, there were several cases where osteoarticular lesions preceded skin lesions in PsA; therefore, care should be taken with regard to oligo- or poly-arthritis patients with a negative rheumatoid factor without the presence of skin lesions.

Herein, we present two cases of older adult patients with highly destructive changes in ankle joints (Larsen grade IV) who underwent retrograde intramedullary ankle nail fixation with fins. In both patients, bony union was achieved, and full weight‐bearing was attained at 3 months after surgery.