M12.04

Clinical Causes: History of rheumatic fever or rheumatic heart disease Persistent inflammation in joints following rheumatic episodes Autoimmune responses that damage joint structures Repeated or untreated cases of streptococcal infections leading to rheumatism

Key Symptoms: Deformity of the hand joints, especially ulnar deviation Pain or tenderness in the affected joints Reduced range of motion in the fingers and wrists Swelling or inflammation in the joints Difficulty gripping or performing fine motor tasks Possible nodules or bumps near affected joints

Diagnosis Path: Diagnosis begins with a detailed medical history, especially previous episodes of rheumatic fever. Physical examination assesses joint deformities, swelling, and range of motion. Imaging studies such as X-rays can reveal characteristic joint changes like subluxation or deformity. Laboratory tests may be used to exclude other joint diseases and to detect markers of inflammation. The history of rheumatic fever paired with characteristic joint features often establishes the diagnosis of Jaccoud’s arthropathy.

Treatment Protocols: While there is no cure for chronic postrheumatic arthropathy, treatment aims to manage symptoms and improve joint function. Approaches include: - **Medications:** Anti-inflammatory drugs, such as NSAIDs, can help reduce pain and swelling. In some cases, corticosteroids are used to control inflammation. - **Physical therapy:** Range-of-motion exercises and physical therapy can maintain joint flexibility and strength. - **Splinting:** Custom splints may be used to support affected joints and prevent further deformity. - **Surgical options:** In severe cases, surgical procedures might be necessary to correct deformities or repair joint damage. Long-term management also involves regular medical monitoring to prevent complications and maintain quality of life.