Artritis psoriatica (inflammatory disease of the joint)

Vincent van Gogh
March 30, 1853, Zundert, Netherlands - July 27, 1890, Auvers-sur-Oise, France

Van Gogh is widely regarded as the greatest Dutch painter and draughtsman since Rembrandt.
He had a profound influence on the Expressionist movement in modern art. His work, painted in a period of barely 10 years, is haunting in its striking colors, rough brushwork, and abstract forms.

♦ La Berceuse ♦
Van Gogh painted five versions of La Berceuse.
They depict Madame Roulin, wife of postman Joseph Roulin, holding a rope in her hand with which she rocks an (invisible) cradle.

♦ Diagnosis
Key symptoms: Swelling of the finger joints, particularly the index finger and the sausage-shaped thickened middle finger of the left hand. Swelling of the finger joints on both hands, skin spots on the back of the hand, yellow fingernails (onycholysis).
Secondary symptoms: Looks older than her 48 years.
Clinical diagnosis: Psoriatic arthropathy is an inflammatory arthritis and/or spondylitis associated with psoriasis.
The peripheral joints are often asymmetrically affected. The rheumatoid factor and subcutaneous nodules are absent. Sausage-shaped fingers (dactylitis) and disorders of the DIP joints are more common than in other forms of arthritis.

♦ Discussion
In the five versions of Madame Augustine Roulin (1851-1930), wife of the postman Joseph Roulin, deformities of the hands can be seen. In four of them, only on the left hand, and in no. 1669, the Annenberg painting (Art Institute Chicago), only on the right hand.
The fact that the deformities of the hands and fingers can be seen in all versions of La Berceuse contrasts sharply with both the flowers decorating the background and the woman's facial expression.
This proves that these deformities are not just an artistic expression, but that they may correspond to reality.
Another painting of Madame Roulin with her baby, now in the Philadelphia Museum of Art, also painted in 1889, a few months before the first version of La Berceuse, also shows abnormalities of the fingers, characteristic of chronic arthritis.

Weinberger also discovered these characteristic finger deformities and described them as rheumatoid arthritis.(1);

The first symptoms of arthritis sometimes appear after pregnancy.
It is noteworthy that changes to the skin can also be seen, such as irregular round spots, which are most noticeable in the replica from January 1889 (no. 1669) from the Art Institute Chicago, USA. They can be seen on both backs of the hands at the joints. These skin changes indicate psoriasis.

Psoriasis is a chronic inflammatory skin disease characterized by the appearance of reddish, silvery-white overlapping scales.
The disease mainly affects the outer parts of the body and the scalp and is associated with chronic arthritis and/or spondylitis.
A sausage-shaped finger, as seen in the paintings on the middle finger of the left hand, is a distinctive feature of psoriatic arthritis.
Changes to the fingernails are often seen in psoriatic arthritis. You can see some of these in the paintings. Nail changes can be as small as a pinprick and are therefore not always visible in the painting.

The five versions of La Berceuse were painted during a turbulent period in Vincent's mental

Source: Jan Dequeker
The artist and the doctor look at paintings


(1); Weinberger A., The artritis of Vincent van Gogh's model, Augustina Roulin. J. Clin. Rheumatol. 1998; 4: 39-40

Jan Dequeker
The artist and the doctor look at paintings

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