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When you compare palindromic rheumatism vs rheumatoid arthritis, one significant difference is clear. Palindromic rheumatism causes joint pain and swelling that appears and disappears, while rheumatoid arthritis leads to joint problems that do not go away and can result in permanent damage.
Most individuals with joint issues do not have palindromic rheumatism. Less than 3% of patients who consult rheumatologists are diagnosed with it. Many people with early rheumatoid arthritis recall experiencing attacks similar to those of palindromic rheumatism.
| Feature | Palindromic Rheumatism | Rheumatoid Arthritis |
|---|---|---|
| Course | Comes and goes | Ongoing |
| Symptom-free periods | Yes | No |
Key Takeaways
- Palindromic rheumatism causes joint pain that comes and goes. Rheumatoid arthritis causes pain all the time and can hurt your joints.
- Keep a diary of your symptoms to help your doctor. This can show patterns and help your doctor find out what is wrong.
- It is important to find out early and get treatment. This can help control symptoms and keep your joints safe from damage.
- If you have stiff joints in the morning or pain that will not go away, talk to your doctor. Your doctor can help you decide what to do next.
- Many people with palindromic rheumatism do not get rheumatoid arthritis. But it is important to watch your symptoms so you can get help early.
Palindromic Rheumatism
What It Is
Palindromic rheumatism is not common. It is a joint problem. You might have sudden pain, swelling, or redness in your joints. These attacks do not last very long.
They can happen weeks or months apart. Your joints feel fine when you are not having an attack. You do not have pain or swelling all the time.
Doctors call this “episodic.” This is a big difference between palindromic rheumatism and rheumatoid arthritis.
Doctors use different rules to diagnose palindromic rheumatism. Here is a table with some of the main rules experts use:
| Criteria Set | Authors |
|---|---|
| First Criteria | Hannonen et al. |
| Second Criteria | Passero and Barbieri |
| Third Criteria | Guerne and Weisman |
| Fourth Criteria | Gonzalez-López |
| Validation Status | None of these criteria have been validated |
None of these rules are officially proven. So, doctors look at your symptoms and your health history to decide if you have it.
Main Features
Palindromic rheumatism has some special signs. You might have:
- Sudden pain, swelling, stiffness, or redness in your joints
- Attacks that last a few hours or a few days
- Joints feel normal after each attack
- No permanent joint damage after attacks
Some people have other problems too, like fever or feeling tired. Rarely, you might get sores in your mouth or on your skin.
Sometimes, there are eye problems, headaches, or fever if the brain or spinal cord gets inflamed. Here is a table of less common symptoms:
| Symptom Description |
|---|
| Sores (mouth and genital) |
| Skin lesions that look like acne |
| Eye inflammation (blurred vision, pain) |
| Gastrointestinal problems |
| Blood clots |
| Inflammation of the brain and spinal cord |
| Lung involvement |
Tell your doctor if you notice any of these symptoms. This helps your doctor understand your health better.
It can help to write down your symptoms in a diary. This lets your doctor see patterns and make a better diagnosis.
Rheumatoid Arthritis
What It Is
Rheumatoid arthritis is a disease that lasts a long time. It affects your joints and makes them hurt and swell. The pain and swelling do not go away.
At first, you may only feel mild pain in your hands or feet. Later, more joints can start to hurt. The problem gets worse as time goes on.
You do not get breaks from symptoms like with palindromic rheumatism. Your joints can feel stiff, mostly in the morning. It might be hard to make a fist or move your fingers.
Rheumatoid arthritis is much more common than palindromic rheumatism. The number of people with this disease is different in each country. Here is a table that shows how many people have rheumatoid arthritis in different places:
| Region | Mean Point Prevalence (%) | Mean Period Prevalence (%) |
|---|---|---|
| North America | 1.46 | 0.69 |
| Africa | 0.80 | 0.19 |
| Europe | 0.53 | 0.60 |
| South America | 0.46 | 0.19 |
| Asia | 0.34 | 0.34 |
| Cuba | 2.70 | N/A |
| Lesotho | 1.80 | N/A |
| Lithuania | 0.92 | N/A |
| Nigeria | 0.00 | N/A |
| Finland | N/A | 1.90 |
| Lebanon | N/A | 1.00 |
| Poland | N/A | 0.90 |
| Taiwan | N/A | 0.09 |
| Philippines | N/A | 0.17 |
| Yugoslavia | N/A | 0.18 |
Main Features
If you have rheumatoid arthritis, you may notice some signs. The symptoms usually start slowly and get worse over time.
Here are some main features:
- Your joints feel stiff and hurt, especially in the morning
- Many joints can swell, often five or more
- Both sides of your body can hurt at the same time
- Fingers, wrists, and feet are usually the first to hurt
- You may feel tired, sad, or have trouble sleeping
Doctors use special rules to help find out if you have rheumatoid arthritis. They look at your symptoms, blood tests, and X-rays.
Here are two sets of rules doctors use:
| Criteria | Description |
|---|---|
| Morning stiffness | Lasts at least 1 hour |
| Arthritis of ≥3 joints | Several joints are swollen |
| Arthritis of hand joints | At least one swollen hand joint |
| Symmetric arthritis | Same joints on both sides hurt |
| Rheumatoid nodules | Lumps under the skin |
| Rheumatoid factor | Positive blood test |
| Radiographic changes | Joint damage seen on X-ray |
| Factor | Points |
|---|---|
| 1 large joint | 0 points |
| 2-10 large joints | 1 point |
| 1-3 small joints | 2 points |
| 4-10 small joints | 3 points |
| More than 10 joints | 5 points |
| Negative RF and ACPA | 0 points |
| Low-positive RF or ACPA | 2 points |
| High-positive RF or ACPA | 3 points |
| Normal CRP and ESR | 0 points |
| Abnormal CRP or ESR | 1 point |
| Duration < 6 weeks | 0 points |
| Duration ≥ 6 weeks | 1 point |
Doctors now use new rules to find rheumatoid arthritis early. This helps you get help sooner and keeps your joints from getting worse.
You might wonder how palindromic rheumatism and rheumatoid arthritis are different. Rheumatoid arthritis causes problems all the time and can hurt your joints. Palindromic rheumatism gives you attacks that come and go, but your joints are fine between attacks.
If you have stiff joints in the morning, swelling in many joints, or trouble making a fist, tell your doctor. Getting help early can make you feel better and protect your joints.
Palindromic Rheumatism vs Rheumatoid Arthritis
Symptoms
Palindromic rheumatism and rheumatoid arthritis can look alike at first. Both can make your joints hurt and swell. But palindromic rheumatism causes quick attacks that come and go.
You feel fine between these attacks. Rheumatoid arthritis causes pain and swelling that stays. The pain does not go away. If you have rheumatoid arthritis, your joints may feel stiff in the morning. This stiffness can last for an hour or longer.
| Symptom | Palindromic Rheumatism | Rheumatoid Arthritis |
|---|---|---|
| Joint Involvement | Changes with each flare; migratory | Usually many joints, often symmetrical |
| Duration of Symptoms | Hours to days; symptom-free between | Persistent and chronic |
| Morning Stiffness | Sometimes during attacks | Prolonged and common |
| Gender Prevalence | Men and women equally | More common in women |
| Joint Erosion | Not seen | Common |
If your pain comes and goes, it could be palindromic rheumatism. If your pain stays and gets worse, rheumatoid arthritis is more likely.
Joint Involvement
Palindromic rheumatism affects different joints at different times. The pain can move from one joint to another. One day your fingers may hurt, the next day your knees might swell. The swelling does not last long. Your joints do not get damaged.
Rheumatoid arthritis usually hurts many joints at once. It often starts in your hands, wrists, or feet. Both sides of your body can hurt at the same time. The swelling does not go away. Over time, your joints can change shape.
| Condition | Joint Involvement Characteristics |
|---|---|
| Palindromic Rheumatism | Sudden, short-term swelling; less swelling at the start |
| Rheumatoid Arthritis | Ongoing swelling; deformities can develop over time |
Palindromic rheumatism can hit different joints each time. Rheumatoid arthritis usually sticks to the same joints.
Flare Patterns
The way flares happen helps tell these two apart. Palindromic rheumatism gives you sudden attacks of pain and swelling. These attacks last a few hours or up to two days. After each attack, your joints feel normal again. You may go weeks or months with no symptoms.
Rheumatoid arthritis is different. The pain and swelling do not go away. You may have better days and worse days, but you always feel some pain or swelling.
Palindromic rheumatism:
-
- Sudden attacks of joint inflammation
- Each attack is temporary
- Joints return to normal between attacks
Rheumatoid arthritis:
-
- Symptoms are always present
- No true symptom-free periods
- Flares can make symptoms worse, but you always feel some pain or swelling
Writing down your symptoms can help you and your doctor see patterns.
Joint Damage
You might worry about joint damage with these conditions. Palindromic rheumatism does not usually cause lasting damage.
After each attack, your joints look and feel normal. Doctors do not see joint erosion on X-rays in most people with palindromic rheumatism.
Rheumatoid arthritis is not the same. The swelling and pain can damage your joints over time. You may see changes on X-rays, like joint erosion or deformity. This damage can make it hard to move and do daily things.
Doctors know that palindromic rheumatism can sometimes turn into rheumatoid arthritis. This happens more often if you have certain antibodies in your blood.
Up to half of people with palindromic rheumatism may get rheumatoid arthritis later. If you have these antibodies, your risk is higher. Some people with palindromic rheumatism have a different immune response, which may lower their risk.
Getting help early can protect your joints, no matter which condition you have.
Symptoms Breakdown
Onset
You may notice the first signs of palindromic rheumatism or rheumatoid arthritis at different ages. Palindromic rheumatism often starts when you are around 49 years old.
Rheumatoid arthritis usually begins a bit later, with most people getting diagnosed at about 56 years old.
Here is a table that shows the average age when each condition starts:
| Condition | Average Age at Diagnosis |
|---|---|
| Palindromic Rheumatism (PR) | 49 years |
| Rheumatoid Arthritis (RA) | 56 years |
Palindromic rheumatism can surprise you with sudden attacks. You might feel fine one day and then wake up with pain and swelling in a joint.
Rheumatoid arthritis usually starts more slowly. You may first notice mild stiffness or pain in your hands or feet. Over time, the symptoms get worse and do not go away.
Swelling
Swelling is a key sign in both conditions. In palindromic rheumatism, swelling comes on quickly and can look dramatic. Your joint may become red, warm, and puffy.
The swelling often goes away completely after the attack ends. In rheumatoid arthritis, swelling builds up more slowly. It tends to last much longer. Your joints may stay swollen for weeks or months. The swelling in rheumatoid arthritis can lead to changes in the shape of your joints over time.
If you see swelling that comes and goes, palindromic rheumatism is more likely. Swelling that stays and gets worse points to rheumatoid arthritis.
Duration
Attacks in palindromic rheumatism do not last long. Most attacks last from a few hours to two days. After each attack, your joints feel normal again.
In rheumatoid arthritis, symptoms stick around. Pain and swelling can last for weeks, months, or even years. You rarely get a break from the discomfort.
Frequency
You may have attacks of palindromic rheumatism every few weeks or months. Some people go long periods without any symptoms. The pattern can change over time. Rheumatoid arthritis works differently. You feel symptoms almost every day. Flares can make things worse, but you rarely have days without pain or swelling.
- Palindromic rheumatism: Attacks come and go, with long breaks in between.
- Rheumatoid arthritis: Symptoms are ongoing, with few or no symptom-free days.
Keeping a symptom diary can help you and your doctor spot these patterns.
Diagnosis
Tests
Doctors use different tests to find out what is wrong. You may need blood tests, scans, and a checkup. Blood tests can show if you have swelling or certain antibodies. Scans help doctors see inside your joints.
- Ultrasound looks for swelling in and around your joints. It can find synovitis, tenosynovitis, and extracapsular inflammation (ECI). ECI is seen in about 61% of people with palindromic rheumatism during a flare.
- MRI gives a clearer picture than ultrasound. MRI can find both synovitis and ECI. This helps doctors tell palindromic rheumatism from rheumatoid arthritis.
- X-rays show if there is any joint damage. In palindromic rheumatism, X-rays usually look normal between attacks.
Your doctor might order more than one test to learn more.
Antibodies
Doctors often check your blood for antibodies. These are special proteins made by your body. Two important ones are rheumatoid factor (RF) and anti-CCP antibodies. These can help doctors tell the two conditions apart.
| Condition | Positive RF (%) | Positive anti-CCP (%) |
|---|---|---|
| Palindromic Rheumatism | 33.3 | 38.9 |
| Rheumatoid Arthritis | 64.3 | 82.9 |
More people with rheumatoid arthritis have these antibodies. About one-third of people with palindromic rheumatism have RF. A little more than one-third have anti-CCP. In rheumatoid arthritis, these numbers are much higher.
If you have anti-CCP antibodies, your doctor may watch you more closely for signs of rheumatoid arthritis.
What Doctors Look For
Doctors look at your symptoms, test results, and how your joints feel. They pay attention to:
- How often you have joint pain and swelling
- If your joints feel warm, sore, or look red during an attack
- If your joints look and feel normal between attacks
- If you feel tired or notice changes in your mood
Doctors use all this information to decide what you have. Keeping a diary of your symptoms can help your doctor make the right diagnosis.
Progression and Outlook
Palindromic Rheumatism Over Time
If you have palindromic rheumatism, you might wonder what happens later. Many people keep having attacks that come and go.
Your joints usually stay healthy between these attacks. Some people never get lasting joint problems. Others may notice changes after some years.
Here is a table showing what happens to people with palindromic rheumatism over time:
| Outcome | RA Group (n=40) | Non-RA Group (n=20) |
|---|---|---|
| Developed chronic RA | 40 (67%) | 0 |
| Died by 2006 | 17 (42%) | 7 (35%) |
| Received joint replacements | 9 (23%) | 0 |
| Mean HAQ score | 0.89 | 0.57 |
| Pain scores similar | Yes | Yes |
Some people with palindromic rheumatism get rheumatoid arthritis, but many do not. Most people in the non-RA group did not need new joints and had less trouble moving.
Rheumatoid Arthritis Over Time
Rheumatoid arthritis often gets worse slowly. You might feel more pain and swelling as years go by. Some people can control their symptoms. Others see their joints get worse.
- Most people with rheumatoid arthritis can do daily things after 10 years.
- About 20% have almost no trouble moving.
- Around 10% have serious problems moving.
- Joint damage can get worse each year. The average X-ray score goes up by about 3 points every year.
- If you keep your disease calm, you may have little joint damage and low trouble scores.
Here is a table showing how rheumatoid arthritis changes over 10 years:
| Disease Activity Level | 10-Year Structural Progression (mTSS) | 10-Year HAQ-DI Score |
|---|---|---|
| Remission | 4.06 (± 4.75) | 0.14 (± 0.33) |
| Low Disease Activity | 14.59 (± 19.76) | 0.53 (± 0.49) |
| Moderate/High Disease Activity | 21.04 (± 24.08) | 1.20 (± 0.62) |
Risk of Progression
You might ask, “Will palindromic rheumatism turn into rheumatoid arthritis?” The answer is not always clear.
Studies show up to half of people with palindromic rheumatism may get ongoing joint problems, most often rheumatoid arthritis. Some research says the risk is about one in three, but it can be higher.
- Not everyone with palindromic rheumatism gets rheumatoid arthritis.
- Many people keep having attacks but do not get lasting joint damage.
- Doctors watch for changes, especially if you have certain antibodies.
If you notice your symptoms change or attacks happen more often, tell your doctor. Getting help early can protect your joints.
When you compare palindromic rheumatism and rheumatoid arthritis, the risk of getting worse is important. You may never get rheumatoid arthritis, but your doctor will help you watch for changes over time.
Treatment
Palindromic Rheumatism
There are different ways to treat palindromic rheumatism. Doctors usually give medicine to help with pain and swelling during attacks.
NSAIDs can make you feel better fast, but they do not work for everyone. Some people use glucocorticoids for quick relief, but doctors do not use them for a long time.
Hydroxychloroquine is the best medicine for many people. Studies show almost half of people who take it have no more symptoms. This medicine can make flares happen less often and not last as long.
If hydroxychloroquine does not help, methotrexate might lower your attacks. Rituximab is another choice if other medicines do not work. Colchicine helps people with certain genes.
Here is a table that lists the main treatments and what studies say:
| Treatment Option | What Studies Show |
|---|---|
| NSAIDs | Help with pain during attacks; results vary |
| Glucocorticoids | Useful for short-term relief; not well studied |
| Hydroxychloroquine | Best choice; 47.78% achieve full control; reduces flares |
| Methotrexate | Helps if HCQ does not work; may lower episodes |
| Rituximab | Improves symptoms in tough cases; some need more than one dose |
| Colchicine | Works for people with certain mutations |
Talk to your doctor about which medicine is right for you.
Rheumatoid Arthritis
There are more ways to treat rheumatoid arthritis. Doctors usually start with DMARDs. Methotrexate is the first medicine most people try.
It works fast, costs less, and helps almost 60% of people by itself. If methotrexate is not right for you, leflunomide, hydroxychloroquine, or sulfasalazine might help.
Doctors sometimes add glucocorticoids if your symptoms are bad. These medicines can lower pain and swelling quickly. You might need more than one medicine to control your disease.
Here are the main treatments for rheumatoid arthritis:
- Methotrexate (first DMARD; helps most people)
- Leflunomide (another DMARD)
- Hydroxychloroquine (often used with other DMARDs)
- Sulfasalazine (another DMARD)
- Glucocorticoids (added if disease is strong)
Starting treatment early can protect your joints and help you stay active. Work with your doctor to find the best plan for you.
Daily Life
Impact
Having palindromic rheumatism or rheumatoid arthritis can change your day. Simple things can get hard when you have a flare. Palindromic rheumatism is hard to predict. You might feel good one day, then struggle the next.
Many people with palindromic rheumatism deal with:
- Sudden pain and swelling that stops you from doing things
- Feeling tired and uncomfortable, even between flares
- Worry and stress because you do not know when a flare will come
- Being afraid of missing work or fun times with friends
- Feeling left out or upset if you cannot join activities
Rheumatoid arthritis usually causes more lasting problems. You might notice:
- Losing strength and having pain that does not go away
- Having trouble with friends or feeling less healthy when pain is bad
- Finding it hard to do daily things if your joints hurt or are stiff
You are not alone. Many people have these problems and learn ways to cope.
Management
You can do things to help your symptoms and stay active. Work with your healthcare team to make a good plan. Here are some tips that can help:
- Ask your doctor before you try new exercises.
- Start with easy, gentle activities.
- Make your muscles stronger to help your joints.
- Try moving your joints to keep them flexible.
- Use water exercises to be gentle on your joints.
- Rest when your body tells you to.
- Use special tools if you need help with tasks.
- Protect your joints by using safe ways to move.
- Try to exercise often.
- Get support from friends, family, or groups.
You can also plan your day by:
- Doing things when you have the most energy.
- Taking breaks so you do not get too tired.
- Doing the most important things first.
- Using good posture and tools that help your body.
Small changes in your daily habits can help you feel better.
Prognosis
How things go for you depends on your diagnosis and risk factors. Some people with palindromic rheumatism never get rheumatoid arthritis.
Others may see their condition change as time goes on. Some things make it more likely to get worse, like having a positive rheumatoid factor, certain joints being involved, being a woman, and getting sick at an older age.
| Factor | Hazard Ratio | p-value |
|---|---|---|
| Positive rheumatoid factor (RF) | 2.9 | 0.002 |
| PIP joint involvement | 2.4 | 0.02 |
| Wrist involvement | 2.5 | 0.05 |
| Female sex | 2.2 | 0.05 |
| Age at onset (per year) | 1.03 | 0.001 |
Most people with rheumatoid arthritis can control their symptoms with good care. Getting help early and making healthy choices can protect your joints and help you live better.
You can find the biggest differences between palindromic rheumatism and rheumatoid arthritis in this table:
| Feature | Palindromic Rheumatism | Rheumatoid Arthritis |
|---|---|---|
| Nature of Symptoms | Sudden, short attacks | Ongoing, persistent pain |
| Radiographic Damage | None | Develops over time |
| Risk of Progression | 50–67% may develop RA | Not applicable |
Finding out what you have early can stop joint damage. This helps you stay active and do things you enjoy. Your doctor can make a plan that fits your needs.
- You can try exercise, massage, or using heat and cold to help with pain.
- Work closely with your rheumatologist to get the best care.
You are not alone. There are many ways and treatments to help you live well.
FAQ
What is the main difference between palindromic rheumatism and rheumatoid arthritis?
Palindromic rheumatism makes joint pain come and go. Rheumatoid arthritis causes pain that does not leave. Palindromic rheumatism does not harm your joints. Rheumatoid arthritis can hurt your joints for good.
Can palindromic rheumatism turn into rheumatoid arthritis?
Yes, it can happen. About half of people with palindromic rheumatism may get rheumatoid arthritis later. Your risk goes up if you have certain antibodies in your blood.
How do doctors diagnose these conditions?
Doctors look at your symptoms and do blood tests. They might use scans to check your joints. They search for patterns in pain and swelling. They also test for antibodies like RF and anti-CCP.
What treatments help with palindromic rheumatism?
You might get medicine to help pain and swelling during attacks. Hydroxychloroquine helps many people feel better. Some people need other medicine if attacks keep happening.
Can you live a normal life with these conditions?
Yes, you can. Many people control their symptoms with medicine, exercise, and support. Getting treatment early helps you stay active and keep your joints safe.
