Patients,

age

Signs of onset

New clinical signs

New paraclinical signs

Retained diagnosis

Duration of follow-up

P1,

54 years

­ Chronic symmetrical peripheral polyarthritis without deformity, without extra-articular signs

­ Biological inflammatory syndrome

­ X-ray of hands, wrists and feet: normal

­ Immunology: negative (rheumatoid factors, ACPA, ANA, anti-ENA, anti-DNAn)

0

ACPA (+) at 7.7 IU/mL

RA

3 years

P2,

67 years

0

Ultrasound of the hands: bilateral synovitis of the MCP and PIP; erosion of the head of the right 2nd metacarpal

RA

4 years

P3,

28 years

Oculo-buccal dry syndrome

Schirmer’s test: positive

Accessory salivary gland biopsy: grade III sialadenitis

Sjögren’s

syndrome

4 years

P4,

43 years

Dry mouth

Accessory salivary gland biopsy: sialadenitis grade IV

Sjögren’s

syndrome

5 years

P5,

33 years

0

ACPA: (−)

ANA: 1/160

SLE

5 years

P6,

32 years

Skin sclerosis (Rodnan score 21/51)

PIP shrinkage

Hypochromic macules in speckles

No further explorations

Systemic

scleroderma

5 years

P7,

19 years

Skin sclerosis (Rodnan score 18/51)

ANA: 1/100

Anti-SSA: 8 IU/mL

ACPA: (−)

X-ray: periarticular calcifications in hands and elbows

Systemic

scleroderma

8 years