Palindromic Rheumatism: A Clinical Survey of Sixty Patients

AbstractHannonen P, Möttönen T, Oka M. Palindromic rheumatism: A clinical survey of 60 patients. Scand J Rheumatology 1987; 16:413–420.Sixty patients with palindromic rheumatism (PR) with a total follow-up time of 598 years and 295 years prospectively are presented. The study shows that PR is not a rare condition, but the syndrome is often ignored or misdiagnosed by the physician. Most cases of PR appear to evolve into chronic arthritis. PR may precede other kinds of systemic diseases, such as SLE, Wegener's granulomatosis, and multiple myeloma. The presence of PR in patients with fibromyalgia is reported in this paper. Gold appears to be the best drug for the treatment of PR. Cases of fibromyalgia and PR are treated successfully with antimalarial drugs. Our proposed diagnostic criteria for PR are as follows: 1) recurrent attacks of sudden-onset mono or polyarthritis or of periarticular tissue inflammation, lasting from a few hours to one week; 2) verification of at least one attack by a physician; 3) subsequent attacks in at least three different joints; 4) exclusion of other forms of arthritides.Key Words: palindromic rheumatismrheumatoid arthritisfibromyalgiasystemic diseaseremission-inducing antirheumatic drugs Additional informationNotes on contributorsP. HannonenJoyce Laing works in the Department of Child and Family Psychiatry, Playfield House, Cupar, Fife, and is a Consultant Art Therapist to Psychiatric Hospitals and Prisons and Chairwoman of the Scottish Society of Art and Psychology.