Jaccoud's arthropathy associated with psoriatic arthritis

Jaccoud arthropathy (JA) was first described in the 19th century by S. Jaccoud in a patient who had several attacks of rheumatic fever. This arthropathy has also been described in patients with systemic lupus erythematosus with estimated prevalence of 5%, and less frequently in other clinical conditions, like primary hyperparathyroidism and psoriatic arthritis. The classic manifestation of JA is the presence of “reversible deformities,” that is reducible to passive movement with preservation of the joint structure. JA generally affects the hands, but can also be observed in feet, knees and shoulders. The most common joint deformities are ulnar deviation, “swan neck,” “boutonniere,” thumb in Z and hallux valgus. Curiously, in older deformities, a limitation of the joint motion can be observed, probably because of fibrosis secondary contractures of the soft tissues of the joint. The etiopathogenic mechanisms are not known.