Jaccoud arthropathy

Jaccoud arthropathy: Description, Causes and Risk Factors: ICD-10-DC: M12.00 Jaccoud arthropathyA rare form of chronic arthritis, reported to occur after attacks of acute rheumatic fever, characterized by an unusual form of bone erosion of the metacarpal heads and by ulnar deviation of the fingers; it resembles rheumatoid arthritis, but with less overt inflammation, and rheumatoid factor is absent. It was traditionally described as occurring post rheumatic fever. It is also seen in association with systemic lupus erythematosus (SLE) and several other rheumatic and non-rheumatic conditions. The etiopathogenic mechanisms of Jaccoud arthropathy are not known, but some authors have suggested an association with hypermobility syndrome. Several studies have attempted to identify an association of different antibodies with Jaccoud arthropathy in SLE patients, but their findings do not allow for the drawing of any definite conclusions. The type of joint deformity that occurs in Jaccoud's arthropathy involves degeneration in the tendon and ligament system, giving the appearance of joint deformity in rheumatoid arthritis but without bone erosion. This arthropathy has been described in patients with systemic lupus erythematosus, rheumatic fever and other collagen diseases. Symptoms: Hand deformities present a typical picture of ulnar deviation and subluxation of the MCP, as observed in rheumatoid arthritis. However, in Jaccoud arthropathy, ligament laxity and muscle imbalance rather than the loss of bone and joint instability secondary to synovitis, determine the clinical picture. Diagnosis: Newer imaging techniques such as magnetic resonance imaging (MRI) and high-performance ultrasonography have revealed the presence of small erosions in joints of a few patients with Jaccoud arthropathy. Treatment: Presently, the therapy for Jaccoud arthropathy is conservative and based on the use of non-hormonal anti-inflammatory drugs, low doses of corticosteroids, methotrexate (TrexallTM). The role of surgery through either the re-alignment of soft tissue around the joint - or more aggressive procedures such as arthrodesis, silastic implant and arthroplasty - needs to be proven. NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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