Jaccoud arthropathy is a deforming non-erosive arthropathy characterized by ulnar deviation of the second to fifth fingers with metacarpophalangeal joint subluxation.
Jaccoud arthropathy is characterized by marked ulnar subluxation and deviation at the metacarpophalangeal joints that is correctable or reducible with physical manipulation 7.
It was traditionally described as occurring post-rheumatic fever. It is also seen in association with systemic lupus erythematosus (SLE) and other rheumatic and non-rheumatic conditions including psoriatic arthritis, inflammatory bowel disease and malignancy 5. It is thought to be related to ligamentous laxity 7.
Typically affects the metacarpophalangeal joints but can also affect the proximal interphalangeal joints of the hands, wrists and knees 2.
- hand radiographs typically show marked ulnar subluxation and deviation at the metacarpophalangeal joints
- absence of erosions is a notable feature, although occasionally "hook" erosions may be observed, which are similar to those seen in SLE and ankylosing spondylitis 6
- evidence of muscle (soft tissue) atrophy also may be present
History and etymology
It is named after F S Jaccoud, a French physician, who described the entity in 1869 3.
On imaging, possible considerations include:
- rheumatoid arthritis: presence of erosions is a key distinction
- 1. Ostendorf B, Scherer A, Specker C et-al. Jaccoud's arthropathy in systemic lupus erythematosus: differentiation of deforming and erosive patterns by magnetic resonance imaging. Arthritis Rheum. 2003;48 (1): 157-65. doi:10.1002/art.10753 - Pubmed citation
- 2. Spina MF, Beretta L, Masciocchi M et-al. Clinical and radiological picture of Jaccoud arthropathy in the context of systemic sclerosis. Ann. Rheum. Dis. 2008;67 (5): 728-9. doi:10.1136/ard.2007.073999 - Pubmed citation
- 3. Jaccoud FS. Sur une forme de rhumatisme chronique. Leçons de clinique médicale faites è l’Hôpital de la Charité. Paris: Delahaye, 1869:598–616
- 4. Fernández A, Quintana G, Rondón F et-al. Lupus arthropathy: a case series of patients with rhupus. Clin. Rheumatol. 2006;25 (2): 164-7. doi:10.1007/s10067-005-1149-y - Pubmed citation
- 5. Palazzi C, D'amico E, De santis D et-al. Jaccoud's arthropathy of the hands as a complication of pyrophosphate arthropathy. Rheumatology (Oxford). 2001;40 (3): 354-5. doi:10.1093/rheumatology/40.3.354 - Pubmed citation
- 6. Pastershank SP, Resnick D. "Hook" erosions in Jaccoud's arthropathy. J Can Assoc Radiol. 1980;31 (3): 174-5. Pubmed citation
- 7. Mittermayer S, Viviane M. Jaccoud’s Arthropathy. (2015) The New England journal of medicine. 373 (1): e1. doi:10.1056/NEJMicm1410743 - Pubmed
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