We report here a rare case of marked calcinosis and rapidly destructive arthropathy associated with anti-Jo1 antibody.
A 74-year-old white woman presented to the rheumatology clinic in 2008 with a 5-year history of polyarthralgia affecting her left hip, right elbow, left shoulder, and hands. Hand and elbow radiographs (Figure 1) showed destructive arthropathy thought to be attributable to severe erosive osteoarthritis or crystal arthritis.
Repeat radiographs in 2010 showed extensive periarticular calcinosis and complete destruction of the right elbow joint.
Similar changes were noted on the repeat hand radiograph in 2012 (Figure 2). Immunological profile revealed strongly positive antinuclear antibody in a nucleolar pattern and anti-Jo1 antibody. Muscle biopsy showed numerous atrophic fibers, but no active inflammation. There was no clinical evidence of interstitial lung disease.
Anti-Jo1 antibody is typically associated with the antisynthetase syndrome, which is characterized by inflammatory myositis, arthritis, Raynaud phenomenon, mechanic’s hands, and interstitial lung disease. Calcinosis and deforming arthropathy, particularly of the hands, associated with anti-Jo1 antibody have been reported infrequently in the literature1,2. However, to our knowledge, such striking calcinosis and rapidly progressive destruction of the elbow joint has not been reported before.