Pustulotic arthro-osteitis complicated by polyarteritis nodosa: a case report

Clicks: 18
ID: 327832
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #27 of 59 articles by views in Modern Rheumatology Case Reports

Most read Least read

Bar heights use a square-root scale.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Pustulotic arthro-osteitis (PAO) is a chronic inflammatory disorder associated with palmoplantar pustulosis (PPP) and characterized by osteoarticular manifestations. Although several immune-mediated comorbidities have been reported in association with PPP/PAO, polyarteritis nodosa (PAN) occurring in patients with PPP/PAO has not been described previously. We report a 56-year-old woman with a long-standing history of PPP and PAO who developed worsening osteoarticular symptoms in close temporal proximity to purpura, lower-extremity pain, and sensory disturbance, followed by paresthesia in the fingers. Neurological examination revealed mild weakness of the left tibialis anterior muscle. Laboratory testing showed elevated inflammatory markers, whereas myeloperoxidase- and proteinase 3-antineutrophil cytoplasmic antibodies were negative. Musculoskeletal imaging revealed bilateral sternoclavicular joint synovitis, inflammatory changes adjacent to the right patellar tendon insertion with infrapatellar bursitis, and right peroneal tenosynovitis. Nerve conduction studies in the lower extremities suggested mononeuritis multiplex. Skin biopsy of a purpuric lesion demonstrated fibrinoid necrosis and inflammatory infiltration in medium-sized arteries within the subcutaneous tissue. The patient was diagnosed with exacerbation of PAO complicated by PAN and was treated with oral prednisolone followed by methotrexate, resulting in rapid normalization of inflammatory markers and improvement in osteoarticular symptoms, purpura, and finger paresthesia, although lower-extremity neurological symptoms persisted at discharge. When patients with PAO develop atypical features such as purpura or neuropathic symptoms suggestive of mononeuritis multiplex, concomitant vasculitis, including PAN, should be considered in the differential diagnosis.
Reference Key
openalex_W7211865605 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Masaki Matsubara, Yoshinori Uenishi, Yuki Hatta, Nobushiro Nishimura, H Kawashima, Ryo Yoneima, Hidetoshi Matsuoka, Shiro Ono, Noritaka Yada, Hiroto Nishimura, Ryota Hara, Takayoshi Morita, Yasuhiro Akai, Kenji Nishio, Kiyomi Yoshimoto
Are you one of these authors? Claim your profile
Journal Modern Rheumatology Case Reports
Year 2026
DOI
10.1093/mrcr/rxag088
URL
https://doi.org/10.1093/mrcr/rxag088
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.