From the Research
Jaccoud's arthropathy is a chronic, non-erosive, rheumatoid-like deformity associated with systemic lupus erythematosus (SLE) and other diseases, characterized by reversible joint deformities such as ulnar deviation, swan neck, and hallux valgus, which can be manually corrected.
Definition and Characteristics
Jaccoud's arthropathy (JA) is a condition that presents with joint deformities that have a "reducible" pattern, meaning they return to normal appearance with a passive maneuver 1. It is most commonly associated with SLE, but can also occur in other diseases such as rheumatic fever, psoriatic arthritis, and connective tissue diseases.
Clinical Features and Diagnosis
The clinical features of JA include ulnar deviation, swan neck deformities, and hallux valgus, which are reversible and can be manually corrected 2, 1. The diagnosis is based on clinical examination and imaging studies, which typically show no bone erosion on plain radiographs, but may reveal small bone erosions on more sensitive imaging methods such as magnetic resonance imaging or high-performance ultrasound 3, 1.
Management and Treatment
The management of JA focuses on treating the underlying inflammatory condition with appropriate immunosuppressive therapy, along with physical therapy to maintain joint function and prevent progression. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help manage pain and inflammation, while hydroxychloroquine is often used for patients with SLE-associated JA 2, 1. Hand splints may be beneficial during acute flares to prevent further deformity, and surgical correction may be considered in severe cases that do not respond to conservative measures.
Pathophysiology and Quality of Life
The pathophysiology of JA involves recurrent inflammation of joint capsules and tendons, leading to ligament laxity and subsequent joint instability and deformity over time 2, 1. As daily activities and quality of life are compromised in patients with JA, further studies are urgently needed to develop effective preventive measures and treatments for this condition 1.