Jaccoud arthropathy (JA) is a non-erosive, deforming arthropathy of the metacarpophalangeal (MCP) and proximal interphalangeal joints, wrists and knees, first described as a rare complication of recurrent rheumatic fever1 and then extensively observed in systemic lupus erythaematosus (SLE) patients.2 3 Hand deformities present a typical picture of ulnar deviation and subluxation of the MCP, as observed in rheumatoid arthritis (RA). However, in JA, ligament laxity and muscle imbalance rather than the loss of bone and joint instability secondary to synovitis, determine the clinical picture.3 4 This hypothesis has been confirmed in an MRI study, as no signs of synovial …