Jaccoud’s arthropathy

Jaccoud's arthropathyA 35-year-old woman presented with symptoms of inflammatory polyarthritis, photosensitivity, oral ulcer and alopecia of 18 months' duration.Investigation revealed thrombocytopenia, non-nephrotic range proteinuria, ANA, anti-dsDNA, anti-Sm, anti-Ro antibodies positivity with low complement.A diagnosis of SLE was made.Her hand examination revealed correctable swan neck deformities involving second to fifth digits on the left and second to fourth digits on the right side (Fig. 1A and B and Supplementary video, available at Rheumatology online) without any erosion on X-ray.This classical correctable deformity without erosion is known as Jaccoud's arthropathy (JA), named after the French physician F. S. Jaccoud [1].Musculoskeletal involvement in SLE occurs in up to 90% of the patients during their disease course.It was classically described with rheumatic fever.Other disease associations are SLE, psoriatic arthritis, inflammatory bowel disease and malignancy [2].It occurs due to ligament and/or joint capsule laxity rather than primary articular involvement affecting primarily metacarpophalangeal joints and rarely proximal interphalangeal joints, wrists and knee joints.The mainstay of therapy for the deformity is supportive, including physical therapy and orthotic devices.Soft tissue corrective surgery is an option though rarely used.