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Harvard Medical School
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General Medical Questions
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Question : What is palindromic rheumatism? Does it progress to rheumatoid arthritis?
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The Trusted Source
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Howard LeWine, M.D.

Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

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January 16, 2013
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A:

Palindromic rheumatism is a type of arthritis that causes sudden inflammation in one or several joints. It lasts a few hours or up to a few days. And then it goes away just as quickly as it began.

Its name comes from the term “palindrome” — a word that is spelled the same way forward and backward. Just think of how “kayak” and “mom” are spelled. This emphasizes how the illness begins and ends in a similar way.

Specific tests, such as analysis of joint fluid, help detect palindromic rheumatism. Without them, it may be hard to distinguish it from other joint problems that come and go, such as gout or pseudogout.

Most experts view palindromic rheumatism as a variant of rheumatoid arthritis. But its course is not predictable.

Consider this:

  • Roughly 1/3 of people with palindromic rheumatism continue with brief episodes of arthritis
  • One-third to one-half goes on to the more constant and chronic joint disease of rheumatoid arthritis.
  • And for a fortunate few (15% in one study), the disease seems to go away on its own.

There is treatment for palindromic rheumatism. It includes:

  • Anti-inflammatory drugs taken at the earliest part of an attack. These drugs include non-steroid anti-inflammatory drugs, corticosteroids or colchicine.
  • If attacks are frequent, long-term treatment with hydroxychloroquine, sulfasalazine or other drugs typically used to treat rheumatoid arthritis (such as methotrexate).

We don’t fully understand the cause, prognosis and best treatment of palindromic rheumatism. Work with your doctor to see what treatment works best for you.

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