Opera-glass deformity and tendon rupture in a patient with systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a disease entity that frequently becomes clinically evident as a generalized arthritis. Despite this common presentation, it is widely accepted that the arthritis of SLE rarely produces severe joint deformity with barely 10% of the patients developing swan neck, boutumiere deformity or a Jaccoud-like arthropathy. An even lesser proportion of patients develop joint erosions and there have been several clinical reports of tendon rupture in patients suffering from the above condition. However, there is still a great deal of controversy concerning the aetiology of the tendon rupture in these patients and while some authors suggest that corticosteroid therapy influences the outcome of this syndrome, pathology studies were included in a small number of these case reports. The subject of the present case report is a patient with SLE and resorptive arthropathy who suffered repeated episodes of tendon ruptures. The local pathologic findings in this patient suggest that the basic disease process was the cause of the tendon ruptures.