Bilateral symmetric polyarthritis with deformities – Is it always connective tissue disease?

Leprosy is a chronic granulomatous infectious disease which is caused by Mycobacterium leprae and has varied manifestations including arthritis. Cutaneous and neurological manifestations are classical presentations of leprosy. Musculoskeletal involvement is the third most common manifestation but is less frequently reported. Joint involvement can present as acute symmetrical polyarthritis or chronic polyarthritis resembling rheumatoid arthritis. Leprosy is seen in high prevalence in some developing countries however, it is rarely seen in non-endemic regions. Arthritis can be present in all types of leprosy. Chronic arthritis is known to exist even in paucibacillary forms, resolved or treated disease and in patients without reaction, suggesting a perpetuated inflammatory process. In these cases leprosy can mimic some autoimmune diseases such as rheumatoid arthritis.