title: [Three cases of Jaccoud's arthropathy during systemic sclerosis].
abstract: BACKGROUND
  Jaccoud's arthropathy (JA) is a chronic and non-erosive deforming arthropathy, usually affecting the hands. JA pathophysiology is poorly known but involves periarticular structures such as tendons and the joint capsule. JA is associated with various conditions including the connective tissue disease, especially systemic lupus erythematosis. JA has been rarely described and studied in systemic sclerosis.
  
  
  METHODS
  We report the clinical histories of 3 patients with systemic sclerosis (ScS) who developed JA. One patient had a systemic limited disease and the 2 others a cutaneous limited disease ; mean age of the patients was 79.3 years. Systemic sclerosis was diagnosed respectively 19, 1 and 21 years prior to the development of JA. One of the 3 patients had a past clinical history of discoid lupus. For 1 out of the 3 patients, JA appeared whereas the ScS was completely stable. The disease was still active in the 2 remaining patients, with concurrent pulmonary hypertension diagnosis. Deformities increased during years (Z thumbs, ulnar deviation), leading to mild to severe disability. No benefit from either prednisone (n=2) or a combination of prednisone and methotrexate (n=1) was obtained.
  
  
  CONCLUSIONS
  We described 3 cases of Jaccoud's arthropathy among our scleroderma cohort of 296 patients (1%). This arthropathy worsens hand functional disability. Its pathophysiology is unknown and optimal therapeutic approach remains to establish.
authors: Service de rhumatologie, pôle hospitalo-universitaire 4, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: A
authors: A
authors: Najm
authors: Service de rhumatologie, pôle hospitalo-universitaire 4, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: B
authors: B
authors: Le Goff
authors: Service de médecine interne, pôle hospitalo-universitaire 3, centre de compétences maladies systémiques et auto-immunes rares, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: A
authors: A
authors: Achille
authors: Service de médecine interne, pôle hospitalo-universitaire 3, centre de compétences maladies systémiques et auto-immunes rares, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: O
authors: O
authors: Espitia
authors: Service de médecine interne, pôle hospitalo-universitaire 3, centre de compétences maladies systémiques et auto-immunes rares, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: C
authors: C
authors: Durant
authors: Service de médecine interne, pôle hospitalo-universitaire 3, centre de compétences maladies systémiques et auto-immunes rares, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
authors: F
authors: F
authors: Perrin
authors: Service de médecine interne, pôle hospitalo-universitaire 3, centre de compétences maladies systémiques et auto-immunes rares, hôpital Hôtel-Dieu, place Alexis-Ricordeau, 44093 Nantes cedex 1, France; Inserm UMR1087, CNRS UMR6291, unité de recherche de l'Institut du thorax, équipe 2 « Signalisation et hypertension artérielle », IRS université de Nantes, 8, quai Moncousu, BP 70721, 44007 Nantes cedex 1, France. Electronic address: christian.agard@chu-nantes.fr.
authors: C
authors: C
authors: Agard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006227:Hand Deformities, Acquired / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging
keywords: Jaccoud's arthropathy; Rhumatisme de Jaccoud; Sclérodermie systémique; Systemic sclerosis