The arthropathy of Behçet's disease

Behçet's disease, originally described as a triad of ocular inflammation and oral and genital ulcerations, is better understood as a mulitsystem disease involving skin, joints, central nervous system, large bowel, and peripheral veins. This report of a 49-year-old female patient with uveitis and recurrent orogenital lesions, polyarthritis, and skin lesions, serves as introduction to a review of articular involvement in Behçet's disease. Included is complete synovial fluid analysis with measurement of intraarticular complement. Arthropathy, occurring in at least one-half of reported patients, is usually polyarticular and asymmetrical. It affects knees and ankles most frequently and rarely produces loss of function or deformity. During exacerbations synovial fluid appears inflammatory with polymorphonuclear leukocytosis greater than 25,000 cells/mul; synovial fluid complement is consistently elevated. Histologically the synovium shows increased vascularity with perivascular lymphocyte infiltration. Etiology and treatment of Behçet's disease are briefly discussed.