116 Jaccoud’s Arthropathy

CASE 116


Jaccoud’s Arthropathy


Hema N. Choudur, Anthony G. Ryan, and Peter L. Munk


Clinical Presentation


As a child, the young woman in this case suffered from an attack of rheumatic fever. Subsequently, she developed mitral stenosis and had a mitral valve replacement. She also developed progressive painless deformity of the hands and feet. On clinical examination, the deformities were reducible with mild compressive pressure on a flat surface. No associated tenderness was elicited.



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Figure 116A



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Figure 116B


Radiologic Findings


Radiographs of the hands and feet (Figs. 116A116F) demonstrate a nonerosive arthropathy of both hands, seen as flexion deformities of the metacarpophalangeal joints with associated ulnar deviation. Hyperextension of the second to fifth proximal interphalangeal joints with flexion deformity of the second and fifth distal interphalangeal joints is also present. No erosions, periarticular osteopenia, or soft-tissue swelling is evident. Similar findings are present in the feet.


Diagnosis


Jaccoud’s nonerosive arthropathy.



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Figure 116C



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Figure 116D



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Figure 116E



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Figure 116F


Differential Diagnosis


On clinical examination, this characteristic deformity may be found in the collagen vascular diseases, especially systemic lupus erythematosus (SLE).


It is very rare that similar radiologic findings may be seen in rheumatoid arthritis, ankylosing spondylitis, or Ehlers-Danlos syndrome.


Discussion


Background

Feb 14, 2016 | Posted by in MUSCULOSKELETAL IMAGING | Comments Off on 116 Jaccoud’s Arthropathy
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