Jaccoud's arthropathy: a rare but well-known clinical entity

Jaccoud arthropathy is a deforming non-erosive arthropathy characterized by ulnar deviation of the 2nd to 5th fingers with metacarpophalangeal joint subluxation that is correctable with physical manipulation [Mittermayer S, Viviane M. Jaccoud's arthropathy. N Engl J Med 2015;373:e1.]. It was traditionally described as occurring post-rheumatic fever but also seen in association with systemic lupus erythematosus, psoriatic arthritis, inflammatory bowel disease, and malignancy [Palazzi C, D'Amico E, De Santis D, Petricca A. Jaccoud's arthropathy of the hands as a complication of pyrophosphate arthropathy. Rheumatology (Oxford) 2001;40:354-355.]. It is thought to be related to ligamentous laxity. It typically affects the metacarpophalangeal joints but can also affect the proximal interphalangeal joints of the hands, wrists, and knees [Spina MF, Beretta L, Masciocchi M, Scorza R. Clinical and radiological picture of Jaccoud arthropathy in the context of systemic sclerosis. Ann Rheum Dis 2008;67:728-729.]. Hand radiographs typically show marked ulnar subluxation and deviation at the metacarpophalangeal joints with absence of erosions. We present a case in a very young female with no prior history of rheumatic fever or acute arthritis at any stage of illness.