Arthritis Digest - What is Palindromic Rheumatoid Arthritis?

Palindromic rheumatoid arthritis is characterized by episodes of pain, swelling, warmth and stiffness of the joints. Individuals affected by the disease also experience recurrent attacks of transient inflammation in and around the joints. It normally afflicts two to three joints and has some typical symptoms and is very difficult to treat.

Fast Facts About Palindromic RA

* Palindromic rheumatoid arthritis is a rare kind of inflammatory arthritis with very distinctive features. It is sometimes referred to as a syndrome, which means that it is a typical condition with a collection of several symptoms

* This type of arthritis is generally characterized by episodes or attacks of pain and swelling of the joints. It also affects tissues that surround the joints.

* These attacks generally involve one to three joints

* The attacks attributable to palindromic rheumatism start suddenly and would last for hours or days before the attacks quickly recede.

* There is high probability of recurrence but with unpredictable frequency.

* This syndrome does not usually lead to permanent joint damage, as differentiated to RA.

* About 30-40 % of those affected by the syndrome develop more frequent episodes as the disease progresses. This may lead to complications including rheumatoid arthritis and their rheumatoid factor may become positive.

* The joints commonly involved with palindromic rheumatism include: the large joints, knees and fingers

* X-ray results will indicate normal condition as joint space narrowing id not present.

Recurrent Episodes of Pain

This type of arthritis gives rise to episodic articular, or periarticular pain. The most common joints that are affected by the disease are those of the fingers and knees.

The pain caused by palindromic rheumatoid arthritis can get intense but will not last longer than two or three days. These episodic attacks stop as quickly as they begin. In about 60% of cases, individuals suffering from this disease may have pain-free phases lasting up to weeks or months. In some instances, the attacks can return after years and may cause no permanent damage.

Rheumatoid Factors in Palindromic RA

There are several factors typical of rheumatoid which are observable in some of the palindromic rheumatoid arthritis patients. Some of these factors include:

* The large joints are the more commonly involved when recurrent episodes of attacks are considered

* Soft tissues of the heel pads and finger pads are the ones affected by the swelling of the periarticular tissues.

* Nodules will develop below the skin in the subcutaneous tissues

* During a typical blood test, increased ESR and CRP levels indicate a rheumatoid factor

Treatment of Palindromic RA

NSAIDs are usually prescribed during attacks associated with palindromic rheumatoid arthritis. The treatment for the syndrome may also include steroid injections or oral steroids. DMARDs and colchicine are now also emerging as modalities to prevent future attacks of palindromic rheumatism.

Generally, the factors that give rise to palindromic rheumatoid arthritis are still uncertain. In the absence of substantive study results, medical experts consider the disease to be a special form of RA.