Palindromic rheumatism
| Palindromic rheumatism | |
|---|---|
| Specialty | Rheumatology  |
Palindromic rheumatism (PR) is a syndrome characterised by recurrent, self-resolving inflammatory attacks in and around the joints, and consists of arthritis or periarticular soft tissue inflammation.[1] The course is often acute onset, with sudden and rapidly developing attacks or flares. There is pain, redness, swelling, and disability of one or multiple joints. The interval between recurrent palindromic attacks and the length of an attack is extremely variable from few hours to days. Attacks may become more frequent with time but there is no joint damage after attacks. It is thought to be an autoimmune disease, possibly an abortive form of rheumatoid arthritis.
Presentation
The exact prevalence of palindromic rheumatism in the general population is unknown, and this condition is often considered a rare disease by non-
Palindromic rheumatism is a syndrome presented with inflammatory para-arthritis (soft tissue rheumatism) and
It typically affects people between the ages of 20 and 50. One study showed an average age of onset of 49.[3]
A population cohort study in Taiwan suggested that patients with PR had an increased risk of developing rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, systemic sclerosis, and polymyositis.[5]
Causes
Palindromic rheumatism is a disease of unknown cause. It has been suggested that it is an abortive form of
Diagnosis
Due to the symptoms of palindromic arthritis and the nature of the attacks, diagnosis can be difficult or take a long time. The symptoms can be similar to many other forms of arthritis or other
No single test can confirm a diagnosis. A
Proposed classification by Guerne and Weismann in 1992:[8]
- A 6-month history of brief sudden-onset and recurrent episodes of monoarthritis or rarely polyarthritis or of soft tissue inflammation.
- Direct observation of one attack by a physician.
- Three or more joints involved in different attacks.
- No radiologic evidence of bone or joint erosion.
- Exclusion of other arthritides, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or gout
Management
Treatment may include nonsteroidal anti-inflammatory drugs (NSAIDs) for acute attacks. Antimalarials, such as hydroxychloroquine, have been helpful in reducing the frequency and duration of attacks and may reduce the likelihood that palindromic rheumatism will progress to rheumatoid arthritis.[9]
Etymology
Palindromic rheumatism derives its name from the Greek palindromos meaning to take the same road once again (palin, again + dromos, pathway) emphasizing how the illness begins and ends in a similar way. The term "palindrome" means a word that is spelled the same forward as backward (examples include "kayak" and "mum").
References
External links