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.


Figure 116A


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.


Jaccoud’s nonerosive arthropathy.


Figure 116C


Figure 116D


Figure 116E


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.



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

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