What is Palindromic Rheumatism

Palindromic rheumatism is a rare condition in which there are episodes of pain, swelling, warmth, and stiffness in the joints. The episodes are unpredictable and can last from hours to weeks. Episodes can happen weeks or months apart.

This condition usually affects people who are 20–50 years old. In about half of people who have this condition, episodes happen more and more often with time. These people are at risk for developing rheumatoid arthritis, a disease that causes pain, swelling, and stiffness in the joints.

What are the causes?

The cause of this condition is not known.

What are the signs or symptoms?

Symptoms of this condition include:

• Sudden, multiple attacks of pain, swelling, warmth, and stiffness in the joints. Usually, 2 or 3 large joints are affected. Different joints may be affected at different times. These attacks happen repeatedly (recur).
• Swelling of the pads of your heels or fingers.
• Firm lumps under the skin (rheumatoid nodules).

How is this diagnosed?

This condition is diagnosed based on:

• Your symptoms.
• A physical exam.
• X-rays.
• Blood tests.

How is this treated?

There is no cure for this condition, but medicines can help relieve pain and inflammation. Your health care provider may recommend:

• NSAIDs to help relieve pain and inflammation.
• Medicines to help relieve inflammation (corticosteroids). These can be taken by mouth or injected into your body.
• Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, hydroxychloroquine, and colchicine. These may reduce how often you have attacks.

Follow these instructions at home:

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Stay physically active. When you have an episode of palindromic rheumatism, reduce physical activity if your condition gets worse. You can increase your physical activity when the episode has ended.
• Eat a well-balanced diet.
• Get plenty of rest.

Contact a health care provider if:

• You have pain and inflammation that does not get better with medicine.
• Your symptoms last more than 2–3 days.

Get help right away if:

• You faint.
• You have periods of extreme weakness.
• You rapidly develop a hot, painful joint that is more severe than usual.
• You have chills.
• Your symptoms suddenly get worse.

Summary

• Palindromic rheumatism is a rare condition in which there are episodes of pain, swelling, warmth, and stiffness in the joints. Episodes can happen weeks or months apart.
• There is no cure for this condition, but your health care provider may recommend medicines that can help relieve pain and inflammation.
• It is important to get help right away if your symptoms worsen.