Arthritis That Comes and Goes: Understanding Palindromic Rheumatism
Palindromic Rheumatism: The Mysterious Arthritis That Comes and Goes
Imagine having painful, swollen joints that suddenly appear—and then just as quickly disappear—leaving you symptom-free until the next flare.
This is the hallmark of palindromic rheumatism (PR), a rare type of arthritis that puzzles patients and doctors alike.
What Is Palindromic Rheumatism?
Palindromic rheumatism is an unusual type of arthritis where joint pain, swelling, and stiffness occur in sudden, short-lived attacks.
Unlike other forms of arthritis, these episodes don’t cause lasting joint damage. Symptoms can vanish completely between flares, sometimes for weeks or even months.
Symptoms of Palindromic Rheumatism
During a flare, patients may experience:
Sudden joint pain and swelling, often in the hands, wrists, or knees
Redness and warmth around the affected joint
Fatigue or mild fever in some cases
Attacks lasting a few hours to several days
Between attacks, people with PR usually feel normal, with no ongoing pain or stiffness.
What Causes It?
Rheumatologist don’t yet know exactly what triggers palindromic rheumatism.
It is considered an autoimmune condition, meaning the immune system mistakenly attacks healthy tissues.
Genetics, environmental factors, or other autoimmune tendencies may all play a role. Importantly, about 1 in 3 people with PR eventually develop rheumatoid arthritis (RA)—a chronic autoimmune arthritis that does cause joint damage.
How Is It Diagnosed?
There’s no single test for palindromic rheumatism. Doctors usually:
Review symptoms and attack history
Rule out gout, lupus, spondyloarthropathy or rheumatoid arthritis
Check for autoantibodies like ANA or rheumatoid factor, which may suggest a higher risk of RA
Because the condition comes and goes, diagnosis often depends on tracking flare patterns over time.
Thus, having recurrent evaluations by your Rheumatologist may be necessary to track symptoms & monitor the disease in order to know if it has transitioned into Rheumatoid Arthritis.
Treatment Options
There is no cure for Palindromic Rheumatism, but treatment aims to reduce the frequency and severity of attacks:
NSAIDs (like ibuprofen) or short courses of steroids such as Prednisone or = may ease pain during flares
Hydroxychloroquine (Plaquenil) is often used to reduce attacks and may lower the risk of progressing to RA
Lifestyle support such as rest during flares, anti-inflammatory diet, and exercise when symptom-free can improve quality of life
Living With Palindromic Rheumatism
The unpredictable nature of PR can be frustrating. Patients often feel anxious, never knowing when the next flare will strike.
Keeping a symptom diary, maintaining regular follow-up with a rheumatologist, and learning about treatment options can help patients feel more in control.
Key Takeaways
Palindromic rheumatism causes sudden, temporary arthritis flares with complete recovery between attacks.
It does not damage joints, but about one-third of patients may later develop rheumatoid arthritis.
Medications and lifestyle changes can reduce attacks and improve daily life.
👉 If you’ve experienced joint pain that comes and goes without explanation, talk with your doctor about palindromic rheumatism. Early recognition and management can make a big difference.