Palindromic Rheumatism

Palindromic rheumatism is a condition that involves episodes of pain, swelling, warmth, and stiffness in the joints. It usually involves 2 or 3 large joints. It may also involve the fingers. The attacks are usually irregular and unpredictable. They may last for hours, days, or weeks. Between attacks, the joints usually improve. You may have weeks or months between attacks where you experience no symptoms.

In about half of people who are affected, attacks may become more frequent. This usually does not lead to permanent joint damage. These people may develop rheumatoid arthritis. Rheumatoid arthritis is a long-term (chronic) inflammatory disease that causes pain, swelling, and stiffness of the joints.

CAUSES

The cause is unknown.

SYMPTOMS

  • Pain, swelling, warmth, and stiffness of large joints.

  • Swelling of the heel pads and finger pads.

  • Firm lumps (rheumatoid nodules) under the skin.

  • Fever.

DIAGNOSIS

Diagnosis is based on your symptoms, a physical exam, X-rays, and blood tests.

TREATMENT

Treatment is aimed at relieving pain and inflammation. Treatment after the start of an attack may include:

  • Over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs may help relieve pain and inflammation.

  • Corticosteroids taken orally or injected into the joint to relieve inflammation.

  • Disease-modifying antirheumatic drugs (DMARDs) such as methotrexate, hydroxychloroquine, and colchicine. Taking these drugs may reduce the frequency of your attacks.

HOME CARE INSTRUCTIONS

  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Remain physically active and reduce activity when your condition gets worse.

  • Eat a well-balanced diet.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have fainting episodes.

  • You have periods of extreme weakness.

  • You rapidly develop a hot, painful joint that is more severe than usual joint aches.

  • You have chills.

  • You have a fever or persistent symptoms for more than 2–3 days.

  • You have a fever and your symptoms suddenly get worse.