We present a case of Jaccoud's arthropathy in a 59-year-old woman. She developed painless correctable ulnar deviation at the metacarpophalangeal joints of both hands following 4 attacks of rheumatic fever. Radiology did not show the hook lesions previously described, but we do not consider this sign essential for the diagnosis. There was no clinical evidence of rheumatoid arthritis. We were able to examine 3 complete joints from the left little finger at necropsy. Pathological examination of this kind has been possible only once before. The histological findings were fibrous thickening of the joint capsule, secondary degenerative changes, presumably due to longstanding joint deformity, and no evidence of significant synovial pathology.
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