| Palindromic Rheumatoid Arthritis Research Information and Support group. | |||||||
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PRESENTATION, DIAGNOSIS,
CAUSES, DESCRIPTION
| Presentation: Palindromic Rheumatoid Arthritis (PRA) is a rare type of inflammatory arthritis that causes sudden inflammation in one or several joints, lasts a few hours or up to a few days, and then goes away completely. The attacks can end as fast as they begin. The pain can be very severe and it is difficult to find relief. The problem usually involves 2 or 3 joints, which have onset over hours and last days - weeks, before subsiding. However episodes of recurrence form a pattern, with symptom free periods between attacks lasting for weeks to months, in some cases, these attacks recur after years. The large joints are most commonly involved. The soft tissues are also involved with the swelling of the periarticular tissues, especially heel pads and the finger pads. Nodules may be found in the subcutaneous tissues. Constitutionally, the patient may or may not have a fever, and swelling of the joints.. |
| Diagnosis: Due to the symptoms of PR and the nature of the attacks, diagnosis can be difficult or take time. The symptoms can be similar to many other forms of arthritis or other auto-immune diseases. It is often a case of eliminating the other conditions before getting the correct diagnosis due to there being no specific test for PR diagnosis. |
| No single test can confirm a diagnosis. A doctor may make a
diagnosis based on medical history and signs and symptoms. Palindromic
Arthritis must be distinguished from acute gouty arthritis and an
atypical, acute onset of rheumatoid arthritis. Without specific tests
(such as analysis of joint fluid), it may be difficult to distinguish
Palindromic Rheumatoid Arthritis (PRA) from other episodic joint
problems. It is important to note that a person may experience more than
one autoimmune disorder at the same time. Laboratory findings are
usually normal. Blood tests may show an elevation of the ESR and CRP,
but are otherwise unremarkable. Rheumatoid factor may be present
especially in the group that is likely to develop rheumatoid arthritis. |
| Causes: Palindromic Rheumatoid Arthritis (PRA) is a disease of unknown cause. It has been suggested that it is an abortive form of rheumatoid arthritis, since anti-cyclinc citrullinated peptide antibiodies (anti-CCP) and antikeratin antibodies (AKA) are present in a high proportion of patients, as is the case in rheumatoid arthritis. Unlike RA and some other forms of arthritis, Palindromic Rheumatoid Arthritis (PRA) affects men and women equally. |
| Description: The unusual features of this syndrome consists of the sudden and rapidly developing afebrile attacks of arthritis or periarthritis, occasionally paraarthritis, that continue for a few hours or a few days and then disappear completely. There is pain, redness, swelling, and disability of one (usually) or multiple joints. The interval between recurrent attacks is extremely variable. There are no joint deformities or roentgenographic manifestations. |