American Board of Internal Medicine (ABIM) Certification Practice Exam

Jaccoud arthropathy is characterized by which of the following?

1. Developing rheumatoid nodules

2. Severe bone erosion

3. Reducible subluxation of the digits

4. Symmetric polyarthritis

The correct answer is: Reducible subluxation of the digits

Jaccoud arthropathy is characterized by reducible subluxation of the digits, which distinguishes it from more progressive forms of arthritis, such as rheumatoid arthritis. This condition typically arises in the context of longstanding rheumatic diseases, particularly systemic lupus erythematosus (SLE). The subluxations observed in Jaccoud arthropathy can be manually corrected, hence the term "reducible." Patients may have a history of joint pain and swelling, but unlike other forms of inflammatory arthritis, Jaccoud arthropathy does not predominantly lead to irreversible joint damage or significant bone erosion. This allows flexibility in joint positioning, contributing to its defining characteristic. Consequently, while associated symptoms like pain and swelling may occur, the key feature that sets Jaccoud arthropathy apart is the presence of these reducible subluxations, usually seen in the metacarpophalangeal (MCP) joints. The other options involve features that are not characteristic of Jaccoud arthropathy. Developing rheumatoid nodules and symmetric polyarthritis are more commonly associated with classic rheumatoid arthritis, whereas severe bone erosion is typically observed in advanced inflammatory arthropathies but not in Jaccoud arthropathy, which generally maintains better joint