Jaccoud's arthropathy in patients with chronic rheumatic valvular heart disease.

In a prospective study over a period of 3 yr, involving all patients with rheumatic valvular heart disease seen at our hospital, we found the diagnostic signs of Jaccoud's arthropathy in 17 of 400 cases (4.2%). All 17 patients had a past history of acute arthritis involving the joints and showed deformities at the time of diagnosis. The valvular lesions were mitral and aortic in 11 cases, mitral in 5 cases and aortic in 1 case. The most frequent joint deformities were: ulnar deviation at the metacarpo-phalangeal joints (12 cases), lateral deviation at the metatarso-phalangeal joints (12 cases), and hammer toe deformity (6 cases). The deformities were reducible in all of them. None of the patients had pain or signs of acute inflammation and functional capacity was normal. Other causes of joint deformity were ruled out by means of radiographic and serologic studies. Jaccoud's arthropathy is not a rare entity and its recognition is important for a differential diagnosis with chronic arthritis of other etiologies, also associated with valvular heart lesions.