Palindromic rheumatism is a type of inflammatory arthritis that causes episodes of joint pain and swelling.
Palindromic rheumatism (PR) is a rare type of inflammatory arthritis that usually appears in people between the ages of 20 and 50.
It causes recurring episodes of joint pain and swelling, but the symptoms disappear between flare-ups.
PR does not cause lasting damage to the joints or surrounding tissue. This makes it different from other types of arthritis such as rheumatoid arthritis (RA). RA can cause permanent damage to your joints. PR may also have a different
The types of inflammation are different as well. An ultrasound of someone with PR shows periarticular inflammation, or swelling around the joint. In contrast, an ultrasound of someone with RA shows intra-articular inflammation, or inflammation with the joint.
A 2019 study suggests that
Not everyone with PR will end up being diagnosed with RA.
The cause of PR is unknown, and scientists are still exploring the risk factors for developing the condition. Even the definition of PR remains controversial.
The word palindrome is derived from Greek roots. “Palin means” “back again,” while “dramein” means “to run.” Palindrome refers to a word that can be read the same backward and forward. Palindromic rheumatism refers to the pattern of symptoms that can go back and forth from one joint to another.
These may vary in the following ways and differ from person to person.
- Duration: Episodes may last a few hours to a few days.
- Frequency: Episodes may occur daily or several times a year.
- Location: Episodes may affect two or three joints at a time and can influence the soft tissue near the joints.
Scientists are still researching the exact causes and symptoms linked to PR.
PR cannot be diagnosed by any one test, and researchers have not yet agreed on specific diagnostic criteria.
Instead, a doctor may use a combination of tests and personal information to come up with a PR diagnosis. This may involve ruling out other conditions. A doctor’s assessment may include:
A doctor may suggest taking nonsteroidal anti-inflammatory drugs (NSAIDs) to treat the swelling. These drugs can help lower inflammation during episodes.
- methotrexate (Otrexup [PF], Xatmep, Trexall)
- sulfasalazine (Azulfidine)
- hydroxychloroquine (Plaquenil)
- leflunomide (Arava)
- azathioprine (Azasan)
The use of DMARDs, including anti-malarial drugs like hydroxychloroquine (Plaquenil), may lower the number and length of attacks in PR. They may also lower the chance of PR developing into RA.
The Arthritis Foundation also recommends the following self-care steps to manage symptoms of PR:
- a healthy balance between activity and rest
- a balanced eating pattern that has plenty of fruits, vegetables, fish, nuts, and beans
- a treatment plan that considers your physical and emotional needs
Larger and more diverse randomized controlled trials are needed to better understand the best treatment strategy for PR.
If you think you may have PR, a doctor can help determine which PR treatment may work best for you.
PR can cause pain and discomfort. But attacks do not cause lasting damage to the joints.
However, people with PR may go on to develop RA. It is estimated that approximately half of people with PR later develop RA.
RA causes your immune system to attack your body’s tissues. RA inflammation can damage your joints, which may lead to bone erosion and joint deformity. If left untreated, it may also affect other parts of your body and lead to long-term health problems.
PR is a rare type of inflammatory arthritis that causes episodes of joint pain and inflammation. While flare-ups do not lead to permanent joint damage, many people with PR go on to develop RA. RA can cause permanent joint damage.
Getting diagnosed with PR by a doctor early on is an important step to managing your symptoms and preventing further complications.