A case of mutilating arthritis has been observed almost from its beginning. The destructive process progressed locally but remained limited to the feet over a period of about four years. Therefore, this disease cannot be considered to be an advanced or a fulminating stage of rheumatoid arthritis. An explanation for the mechanism of the development of this unique deformity was suggested by the early roentgenographic findings. There is apparently an unusual periosteal reaction of the bones bordering the affected joints which leads at first to new-bone formation and later to excessive bone resorption with mutilation. Since the relationship of mutilating arthritis to psoriasis and to rheumatoid arthritis has not been established, it appears useful to consider this entity a separate one for the purpose of early correct diagnosis. Prolonged oral administration of cortisone gives great symptomatic relief but does not seem to influence the natural course of this disease.
A review of the literature indicates that our patient is probably the youngest patient in whom this disease has been reported.