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Palindromic rheumatism is a disease of unknown cause characterized by frequent recurring attacks (at irregular intervals) of acutely inflamed joints. Periarticular pain with swelling and transient subcutaneous nodules may also occur. The attacks cease within several hours to several days. The knee and finger joints are most commonly affected, but any peripheral joint may be involved. Although hundreds of attacks may take place over a period of years, there is no permanent articular damage. Laboratory findings are usually normal. Palindromic rheumatism must be distinguished from acute gouty arthritis and an atypical acute onset of rheumatoid arthritis. In some patients, palindromic rheumatism is a prodrome of rheumatoid arthritis.

Symptomatic treatment with NSAIDs is usually all that is required during the attacks. Hydroxychloroquine may be of value in preventing recurrences.

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Corradini  D  et al. How should we treat palindromic rheumatism? A systematic literature review. Semin Arthritis Rheum. 2021;51:266.
[PubMed: 33401055]  

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