General
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• Autoimmune disease that usually presents with mild arthritis or joint effusions
• Destructive joint disease is rare except for those on steroid therapy who rarely can develop aseptic necrosis
• Occasionally there is a progression to rheumatoid-like nonerosive hand deformities (Jaccoud's syndrome, Rheum Dis Clin North Am 1988;14:99, Ann Rheum Dis 1974;33:204)
• Synovial fluid shows less inflammation than rheumatoid arthritis

Clinical images
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Correctable swan-neck deformities and ulnar deviation

 

Readily correctable swan-neck deformities and subluxation of right fifth MCP

Metacarpal heads-no cartilage damage seen

Non-correctable deformities of PIP joints

Mild ulnar deviation, especially on right

Micro description
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• Changes resemble rheumatoid arthritis, but with more intense surface fibrin deposition and less synovial proliferation and less intense inflammation
• Occasional vasculitis can be seen (Ann Intern Med 1971;74:911)

Micro images
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Synovial membrane

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