Palindromic rheumatism
Encyclopedia
Palindromic Rheumatism consists of sudden and rapidly developing attacks of arthritis
. There is acute pain, redness, swelling, and disability
of one (usually) or multiple joints. The interval between recurrent attacks is extremely variable and how long the attack lasts is also variable. There is no joint damage after attacks.
or other auto-immune diseases. It is often a case of eliminating the other conditions before getting the correct diagnosis due to there being no specific test for PR diagnosis.
No single test can confirm a diagnosis. A doctor
may make a diagnosis based on medical history and signs and symptoms. Palindromic rheumatism must be distinguished from acute gout
y arthritis and an atypical, acute onset of rheumatoid arthritis
(RA). Without specific tests (such as analysis of joint fluid), it may be difficult to distinguish palindromic rheumatism from other episodic joint problems. It is important to note that a person may experience more than one autoimmune disorder at the same time. Laboratory
findings are usually normal. Blood
tests may show an elevation of the ESR
and CRP
, but are otherwise unremarkable. Rheumatoid factor
may be present especially in the group that is likely to develop Rheumatoid arthritis
.
Anti-citrullinated protein antibody
is frequently associated.
" — a word that is spelled the same forward as backward (examples include "kayak" and "mom") — emphasizing how the illness begins and ends in a similar way.
From the Greek "palindromos" meaning to come and go (pálin again or back + dromos running).
may be found in the subcutaneous tissues. Constitutionally, the patient may or may not have a fever
, and swelling of the joints.
, since anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) are present in a high proportion of patients, as is the case in rheumatoid arthritis
. Unlike RA and some other forms of arthritis
, palindromic rheumatism affects men and women equally.
It typically affects people between the ages of 20 and 50. One study showed an average age of onset of 49.
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
. There is acute pain, redness, swelling, and disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
of one (usually) or multiple joints. The interval between recurrent attacks is extremely variable and how long the attack lasts is also variable. There is no joint damage after attacks.
Diagnosis
Due to the symptoms of PR and the nature of the attacks, diagnosis can be difficult or take time. The symptoms can be similar to many other forms of arthritisArthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
or other auto-immune diseases. It is often a case of eliminating the other conditions before getting the correct diagnosis due to there being no specific test for PR diagnosis.
No single test can confirm a diagnosis. A doctor
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...
may make a diagnosis based on medical history and signs and symptoms. Palindromic rheumatism must be distinguished from acute gout
Gout
Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most commonly affected . However, it may also present as tophi, kidney stones, or urate...
y arthritis and an atypical, acute onset of rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
(RA). Without specific tests (such as analysis of joint fluid), it may be difficult to distinguish palindromic rheumatism from other episodic joint problems. It is important to note that a person may experience more than one autoimmune disorder at the same time. Laboratory
Laboratory
A laboratory is a facility that provides controlled conditions in which scientific research, experiments, and measurement may be performed. The title of laboratory is also used for certain other facilities where the processes or equipment used are similar to those in scientific laboratories...
findings are usually normal. Blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
tests may show an elevation of the ESR
ESR
ESR may refer to:Technology:* Electro Slag Remelting* Electronic Staff Record, a human resources and payroll system of the UK National Health Service...
and CRP
CRP
-Biochemistry and medicine:* C-reactive protein , an acute phase protein produced by the liver* cAMP receptor protein is a regulatory protein in bacteria* Collagen-related peptides...
, but are otherwise unremarkable. Rheumatoid factor
Rheumatoid factor
Rheumatoid factor is an autoantibody most relevant in rheumatoid arthritis. It is defined as an antibody against the Fc portion of IgG. RF and IgG join to form immune complexes that contribute to the disease process...
may be present especially in the group that is likely to develop Rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
.
Anti-citrullinated protein antibody
Anti-citrullinated protein antibody
Anti-citrullinated protein antibodies or anti-cyclic citrullinated protein antibodies are autoantibodies that are frequently detected in the blood of rheumatoid arthritis patients...
is frequently associated.
Terminology
Palindromic Rheumatism derives its name from the term "palindromePalindrome
A palindrome is a word, phrase, number, or other sequence of units that can be read the same way in either direction, with general allowances for adjustments to punctuation and word dividers....
" — a word that is spelled the same forward as backward (examples include "kayak" and "mom") — emphasizing how the illness begins and ends in a similar way.
From the Greek "palindromos" meaning to come and go (pálin again or back + dromos running).
Presentation
It is a rare type of inflammatory arthritis that causes sudden inflammation in one or several joints, lasts a few hours or up to a few days, and then goes away completely. The problem usually involves 2 or 3 joints, which have onset over hours and last days - weeks, before subsiding. However episodes of recurrence form a pattern, with symptom free periods between attacks lasting for weeks to months. The large joints are most commonly involved. The soft tissues are also involved with the swelling of the periarticular tissues, especially heel pads and the finger pads. NodulesNodule (medicine)
For use of the term nodule in dermatology, see Nodule In medicine, a nodule refers to a relatively hard, roughly spherical abnormal structure....
may be found in the subcutaneous tissues. Constitutionally, the patient may or may not have a fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
, and swelling of the joints.
Causes
Palindromic rheumatism is a disease of unknown cause. It has been suggested that it is an abortive form of rheumatoid arthritisRheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
, since anti-cyclic citrullinated peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) are present in a high proportion of patients, as is the case in rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
. Unlike RA and some other forms of arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
, palindromic rheumatism affects men and women equally.
It typically affects people between the ages of 20 and 50. One study showed an average age of onset of 49.
External links
- The IPRS website Retrieved Sept. 5, 2006.