What Is Palindromic Rheumatism? Causes, Symptoms, and Treatment
Palindromic rheumatism draws its name from the root word “palindromic,” which means “to come and come again.” The name Palindromic rheumatism is meant to tell you that this joint condition begins and ends in a similar way—suddenly.
Click through this slideshow to learn about this type of rheumatic disorder. Talk with your doctor if any of the symptoms match what you’re currently experiencing.
What Is Palindromic Rheumatism?
Palindromic rheumatism (PR) is a rare type of arthritis, and is closely related to a more common condition, rheumatoid arthritis (RA). In the case of RA, chronic inflammation and swelling in the joints can lead to bone damage and joint destruction that progresses over time.
PR causes sudden bouts of joint pain and swelling. These episodes typically occur in the hands or feet, and they may be recurring. When you’re not experiencing a PR episode, your joints will appear completely normal on an X-ray.
What Are the Symptoms of Palindromic Rheumatism?
People with PR may experience one of the following symptoms during a PR episode:
- sudden, rapidly developing attacks of joint pain and swelling
- redness, pain, and swelling in the affected joints
- temporary disability of a joint or joints
- recurring attacks in the affected joints
Symptoms typically occur in the hands and feet. However, any joint can be affected.
How Long Do Palindromic Rheumatism Episodes Last?
An episode of pain and swelling caused by PR can be as short as a few hours or as long as several days. Lengths of a PR episode vary from person to person.
PR episodes may occur quite frequently for a short period of time and then almost seem to disappear. In other people, PR episodes are rare and happen infrequently. Still others may experience episodes regularly, even on a predictable schedule.
What Causes Palindromic Rheumatism?
Researchers do not know what causes PR. However, they do believe PR is strongly connected to RA. People with PR often have many of the same protein markers as people with RA. Therefore, doctors believe PR may be one condition on a spectrum of rheumatic disorders related to RA.
Additionally, research suggests there may be an important connection between PR and antiphospholipid syndrome. The immune symptom of a person with this syndrome mistakenly produces antibodies against normal proteins in the body.
What Are the Risk Factors for Palindromic Rheumatism?
Researchers have been unable to identify a common thread among people with PR. That means they have been unable to determine who will get PR and who won’t. However, they have identified several risk factors:
How Is Palindromic Rheumatism Diagnosed?
The fleeting nature of PR attacks and the lack of visible damage to joints make a diagnosis difficult. There’s no single test that can diagnose PR. Additionally, the symptoms of PR may be confused with other types of arthritis or disorders. This may further complicate the diagnosis.
PR is typically diagnosed when all other potential causes have been identified and eliminated. Your doctor will take into account your health history and the symptoms you experience when making a diagnosis.
Can Palindromic Rheumatism Cause Other Problems?
In rare cases, a person with PR may eventually develop RA. This progression can be very slow, and not everyone will be affected. Doctors don’t have a way to identify which patients will progress to RA and which won’t. Therefore, it’s important to stay aware of changing symptoms in your body, and notify your doctor as soon as you can if you suspect a new or worsening problem.
How Is Palindromic Rheumatism Treated?
PR is often treated with the same medicines used to treat malaria. Though it may sound odd, research has shown that these medicines reduce the duration of PR attacks on your joints. Also, malaria medicines have been found to reduce the likelihood that PR will progress to RA.
Additionally, your doctor may suggest you take nonsteroidal anti-inflammatory drugs (NSAIDS). NSAIDS may help reduce inflammation and swelling in the affected joints. They may also reduce the likelihood that PR will progress to chronic RA.
- Palindromic rheumatism: Does it cause joint pain? (2011, 14 May). Mayo Foundation for Medical Education and Research. Retrieved November 30, 2013, from http://www.mayoclinic.com/health/palindromic-rheumatism/HQ01171.
- Palindromic rheumatism. (2013, 13 Oct). National Center for Advancing Translational Sciences (NCATS). Retrieved November 30, 2013, from http://rarediseases.info.nih.gov/gard/7304/palindromic-rheumatism/resources/1.
- Salvador G, Gomez A, Vinas O et al. (2003, Aug). Prevalence and clinical significance of anti-cyclic citrullinated peptide and antikeratin antibodies in palindromic rheumatism. An abortive form of rheumatoid arthritis? Rheumatology, 42 (8): 972–5. Retrieved November 30, 2013, from http://rheumatology.oxfordjournals.org/content/42/8/972.long
- Powell A, Davis P, Jones N, Russell AS (2008, June). Palindromic rheumatism is a common disease: comparison of new-onset palindromic rheumatism compared to new-onset rheumatoid arthritis in a 2-year cohort of patients. The Journal of Rheumatology, 35 (6): 992–4. Retrieved November 30, 2013, from http://www.ncbi.nlm.nih.gov/pubmed/18412310.
- Round 1 : Palindromic Rheumatism. (2005, Dec 1). The Johns Hopkins Arthritis Center. Retrieved November 30, 2013, from http://www.hopkinsarthritis.org/physician-corner/rheumatology-rounds/round-1-palindromic-rheumatism/.