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June 28, 1965

Unusual Arthropathy in Periodic Peritonitis

Author Affiliations

From the divisions of diagnostic radiology and orthopedic surgery, University of Washington School of Medicine, Seattle.

JAMA. 1965;192(13):1162-1164. doi:10.1001/jama.1965.03080260050020

ARTHRALGIA WITH FEVER is a common manifestation of periodic peritonitis, an hereditary affliction of Mediterranean peoples (synonyms: familial recurring polyserositis, familial Mediterranean fever, etc). Roentgenographic evidence for permanent joint change is unusual and when present has been limited to large weight-bearing joints. The small joints of the feet and hands have been said never to be involved in this disease,1 and no roentgenographic or pathological evidence for such involvement has been presented before, to our knowledge.

Report of a Case 

Present Illness.—  The patient, a Jewish woman of Sephardic origin, was first seen at the age of 22 years. She had suffered intermittent abdominal pains for at least 15 years. The attacks were characterized by belching, aerophagia, diarrhea, and, in recent years, by "doubling-up" abdominal pain beginning in the epigastrium and eventually settling in one or both lower quadrants. Each episode lasted 2 to 3 days and was accompanied