Jaccoud Arthropathy in Systemic Lupus Erythematosus

Abstract

Jaccoud arthropathy (JA) was initially described in patients with rheumatic fever and later in several other rheumatologic conditions, particularly systemic lupus erythematosus (SLE). In patients with the latter disorder, a prevalence of about 5% has been observed. We conducted the current study to describe a series of patients with SLE with JA, followed at the Hospital Santa Izabel, Salvador, Brazil, during the year 2006. We reviewed the literature on JA, with emphasis on the histologic, clinical, radiologic, and therapeutic aspects of the condition. Twenty-one patients with JA were identified, corresponding to a prevalence of 3.47% in the population of 606 patients with the diagnosis of SLE attended in our service. Twenty patients were women, and the mean age was 40.2 +/- 8.8 years (range, 24-55 yr). The most frequently found joint deformities were swan neck and thumb subluxation, both identified in 14 patients. Ulnar deviation was seen in 8, boutonniere deformity in 3, and hallux valgus in 2 patients. We found no difference in the clinical or laboratory features in SLE patients with or without JA. The patients with JA presented a trend toward a lower quality of life compared with the patients with SLE without JA, but without statistical significance.

Ultrasonographic assessment of bone erosions in the different subtypes of systemic lupus erythematosus arthritis: comparison with computed tomography

“…Arthritis in systemic lupus erythematosus (SLE) is usually non-erosive on x-ray, even in the 5–15 % of patients with long-standing disease who develop hand and foot deformities as hallmarks of Jaccoud’s arthropathy (JA) [ 1 , 2 ]. An exception is represented by rhupus syndrome, which affects fewer than 5 % of patients and is characterized by erosions on radiographs of the hands and feet, persistent synovitis and a high titer of anti-cyclic citrullinated peptide (aCCP) antibodies, and may be considered an overlap between rheumatoid arthritis (RA) and SLE [ 3 , 4 ].…”

Spontaneous flexor tendon rupture due to an insufficiency fracture of the hamate hook in a patient with systemic lupus erythematosus: A case report

“…Chronic synovitis and tenosynovitis, arthritis, hand deformities such as Jaccoud’s arthropathy, local steroid injections, and long-term oral steroid use can contribute to degeneration and increase the vulnerability of the flexor tendon in patients with SLE [5], [6], [7]. There have been case reports of spontaneous tendon rupture in patients with SLE such as the Achilles tendon, patellar tendon and digital extensor tendons, but there have been few reports regarding flexor tendon rupture [8], [9], [10].…”

Avaliação Funcional Da Mão Em Pessoas Com E Sem Artropatia De Jaccoud Associada Ao Lúpus

“…Até que se tenha a análise precisa da condição de saúde, o indivíduo pode receber diferentes hipóteses de diagnóstico, o que muitas vezes implica no tratamento tardio 5 . A artropatia de Jaccoud (AJ) é uma manifestação clínica que foi primariamente descrita em associação com a febre reumática, mas já é possível ser observada em doenças do tecido conectivo, no LES 6,7,8 , a dermatomiosite 9 , inflamações intestinais, artrite psoriásica, entre outras 5,10,11 .…”

“…Atinge comumente as metacarpofalangianas (MF) e interfalangeanas (IF) dos quirodáctilos e pododáctilos 5 . A prevalência epidemiológica da AJ é de 5% para pacientes com LES 10,11 . Por ser um distúrbio raro, os dados epidemiológicos e clínicos da AJ são retratados na literatura por meio de relatos de caso…”

“…Foi identificado um desvio ulnar, dos punhos e dedos no grupo com AJ. Provavelmente, devido a redução de força de preensão palmar e, como compensação, os músculos que participam da preensão 10,16 levam os quirodáctilos à adução, flexão e desvio ulnar do punho e dos dedos 5,10 . Outra justificativa pode ser por pessoas com AJ possuírem cápsulas articulares distendidas e os tendões extensores encurtados para lado ulnar dos metacarpos, com consequente desvio ulnar…”