Palindromic Rheumatism | Risk Factors for Development of Connective Tissue Disorder

 

Palindromic rheumatism consists of:

(1) multiple sudden, recurrent, afebrile episodes of joint pain with swelling and erythema

(2) usually involves a single or a few (oligo) joints

(3) disability during attacks but complete remission between episodes

 

Some patients have complete resolution over time, some have repeated attacks without progression to a connective tissue disease, while others do progress to rheumatoid arthritis, SLE or other connective tissue disease.

 

Risk factors for progression to a connective tissue disease (hazard ratios from 2.2 to 2.9):

(1) female gender

(2) positive rheumatoid factor (RF)

(3) involvement of the proximal interphalangeal (PIP) joints

(4) involvement of the wrists

(5) duration of disorder (hazard ratio 1.03 per year with the disorder; it would take 23 years for the hazard ratio to rise to 2)