Abstract
Out of 300 patients with definite SLE observed at the Institute of Rheumatology for 20 years 60 (20%) developed deforming polyarthritis. Arthralgias appeared to be the initial sign of the disease in 25 % of the patients, recurrent synovitis in 20 %. A great majority of the patients had pronounced hand involvement. Hand deformities as a rule appeared 5-10 years after the onset of the disease: ulnar deviation, subluxations of metacarpophalangeal joints, swan neck or boutonnière deformities of fingers, hyperextension of the thumb interphalangeal joint.Elbows, knees, ankle joints and feet became involved in approximately in 50 % of the patients. Deformities were not pronounced but a number of patients had constant knee and elbow joint synovitis leading gradually to joint deformation. X-ray examination did not reveal gross destructive changes, though some patients had slight erosive bone changes. Aseptic necrosis of bones appeared to be a special problem. Rheumatoid factor (latex test) was not permanently present and as a rule in 1/20-1/40 litres.
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