Jaccoud's arthropathy in systemic lupus erythematosus: clinical, laboratory and ultrasonographic features.
OBJECTIVE
Jaccoud's arthropathy (JA) is a deforming, non-erosive arthritis, occurring in 2-35% of systemic lupus erythematosus (SLE) patients. We aimed to evaluate JA patients in a wide monocentric SLE cohort in terms of clinical, serological and ultrasonographic features.


METHODS
Consecutive SLE patients (ACR criteria 1997) were evaluated. The JA index was applied for patients with reducible deformities. Patients with a JA index ≥5 underwent physical examination, blood testing and ultrasound (US) assessment. Detection of anti-citrullinated protein antibodies (ACPA) and rheumatoid factor (RF) was performed. A single rheumatologist performed the US assessment of bilateral wrist and hands.


RESULTS
Four hundred and eighty SLE patients were evaluated: 17 (3.5%) showed a JA index ≥5 (M:F 1:16; mean age±SD 50.7±11.1 years; mean disease duration±SD 247.8±116.2 months). Four patients (23.5%) showed ACPA positivity. Fifteen patients (88.2%) showed at least one US abnormality. Bone erosions were found in 10 patients (58.8%). ACPA+ve patients showed erosive damage more frequently in at least one joint compared with ACPA-ve (75% vs. 53.8%, p=0.002).


CONCLUSIONS
JA should no longer be considered a non-erosive condition since bone damage can occur in more than half of patients. Moreover, the erosive damage seems to be associated with the presence of ACPA.
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Fulvia
F
Ceccarelli
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Laura
L
Massaro
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Carlo
C
Perricone
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Monica
M
Pendolino
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Enrica
E
Cipriano
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Simona
S
Truglia
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Francesca
F
Miranda
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Francesca Romana
FR
Spinelli
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy. cristiano.alessandri@uniroma1.it.
Cristiano
C
Alessandri
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Guido
G
Valesini
Lupus Clinic, Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Italy.
Fabrizio
F
Conti
D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D001847:Bone Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging* / Q000209:etiology / Q000276:immunology; D050823:Hand Joints / Q000000981:diagnostic imaging; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000209:etiology / Q000276:immunology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010456:Peptides, Cyclic / Q000276:immunology; D012217:Rheumatoid Factor / Q000276:immunology; D014955:Wrist Joint / Q000000981:diagnostic imaging*
D001323:Autoantibodies; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D012217:Rheumatoid Factor