Rheumatic manifestations of Wegener's granulomatosis

Wegener's granulomatosis is a necrotizing granulomatous vasculitis with multisystem involvement. We reviewed the rheumatic manifestations among 50 patients with Wegener's granulomatosis. Arthralgia, myalgia and/or arthritis occurred in 2/3 of patients and 28% had nonerosive and nondeforming polyarthritis. Noninflammatory synovial fluid was found upon arthrocentesis of one patient with a knee effusion. Unexpected findings included soft tissue calcifications in 9 patients, sacroiliitis in 3, and relapsing polychondritis in 2. Rheumatoid factor was present in 1/2 of the patients tested. Additionally, both antinuclear antibodies and anti-DNA antibodies were detected in 14 and 38%, respectively, of patients tested.