[Sigismond Jaccoud (1830–1913), Swiss physician and professor of internal pathology at several hospitals in Paris]

= irreversible nonerosive deforming arthropathy after subsidence of frequent severe attacks of rheumatic fever / SLE

• Rheumatoid arthritis + SLE may occur simultaneously!

Path: pericapsular soft-tissue edema (= synovitis around small joints); periarticular fascial + tendon fibrosis

• rheumatic valve disease

Location: primarily involvement of hands; occasionally in great toe

• periarticular swelling of small joints of hands + feet
• ulnar deviation + flexion of MCP joints most marked in 4^th + 5^th finger
• >3 mm distance between scaphoid and lunate / other carpal bones = carpal instability (in 15% of SLE)
• swan neck + boutonniere deformity
• NO joint narrowing / erosion
• juxtaarticular osteoporosis
• muscular atrophy