P67 Jaccoud’s arthropathy in systemic lupus erythematosus: a case series of 52 Brazilian patients

Abstract

Background Jaccoud’s arthropathy (JA) is a condition characterized clinically by ‘reversible’ joint deformities such as swan neck, thumb subluxation, ulnar deviation, ‘boutonniere’ and hallux valgus, along with an absence of articular erosions on a plain radiograph. JA was initially described in patients with rheumatic fever (RF), but presently the main clinical entity associated to JA is systemic lupus erythematosus (SLE). In general its prevalence in either SLE or RF is around 5%. The aim of the present study is to describe a series of SLE patients with JA, followed up at two referral lupus centers in Brazil. Methods The patients included in this study met the SLE classification criteria proposed by the American College of Rheumatology and also presented JA based on previously proposed criteria. Data collection was obtained through interviews, general physical examination with emphasis on the musculoskeletal system and review of medical records. The patients were originated from two SLE referral outpatient clinics in Salvador, Brazil and the search was conducted throughout 2018–2019. Results Fifty-two patients with JA were included being 51 female, mean age was 48 ± 13 years and mean disease duration was 19 ± 7 years. The most frequently found joint deformities were swan neck [49/52 (94%)]; ulnar deviation [32/52 (61%)] and thumb subluxation [23/52 (44%)]. Discussion To the best of our knowledge it is the largest case series of JA in SLE ever described. Some patients have been included in previous studies developed by our group. Based on the findings of such studies some conclusions can be drawn: 1) Although in the majority of the cases JA is a ‘correctable’ arthropathy sometimes the joints are fixed, resembling those seen in rheumatoid arthritis, even in the absence of bone erosions. 2) The level of interleukin 6 is higher in SLE patients with JA as compared to those without such complication. 3) Classically in JA no erosion is seen on plain radiographs, however its presence on magnetic resonance imaging or high-performance ultrasound examination is not so rare.