Rare Rheumatology News

Disease Profile

Palindromic rheumatism

Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.


US Estimated

Europe Estimated

Age of onset





Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease.


Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype.


dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.


recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder.


Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.


Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.


Not applicable


Other names (AKA)

Palindromic rheumatism syndrome; Hench-Rosenberg syndrome; Hench's syndrome


Immune System Diseases


Palindromic rheumatism (PR) is a type of recurrent arthritis characterized by episodes or "attacks" of joint inflammation, sequentially affecting one to several joint areas for hours to days.[1][2] A PR attack often occurs suddenly without any obvious triggers or warning symptoms. Any joint(s) may be affected, but finger joints, wrists, and knees are most commonly affected.[2] Symptoms during episodes may include pain, swelling, stiffness, and redness in and around the joints.[2] Some people may have a fever and other systemic symptoms.[3] Between episodes, people with PR have no symptoms.[2] The time between episodes may last from days to months.[1]

The underlying cause of PR is not known.[2] Some people with PR eventually develop chronic rheumatic disease, the most common being rheumatoid arthritis (RA). Others may develop lupus and/or other systemic disorders. People with anti-CCP antibodies detected in a blood test appear more likely to develop RA.[1] There has been some evidence to support that PR can be a presenting feature of RA (or part of the spectrum of RA), rather than a distinct condition.[2] [4]

Treatment of PR is challenging, as it has not been studied in randomized trials.[5] Nonsteroidal anti-inflammatory drugs (NSAIDs) may be used to treat acute episodes. Disease-modifying antirheumatic drugs (DMARDs) may be an option for those with refractory, frequent attacks.[5] Hydroxychloroquine (a DMARD) reportedly may help control attacks and reduce the risk of progression to RA.[2][4]


Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

    Social Networking Websites

      Organizations Providing General Support

        Learn more

        These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

        In-Depth Information

        • PubMed is a searchable database of medical literature and lists journal articles that discuss Palindromic rheumatism. Click on the link to view a sample search on this topic.


          1. PJW Venables, Ravinder N Maini. Diagnosis and differential diagnosis of rheumatoid arthritis. UpToDate. Waltham, MA: UpToDate; January, 2016; https://www.uptodate.com/contents/diagnosis-and-differential-diagnosis-of-rheumatoid-arthritis.
          2. Emad Y, Anbar A, Abo-Elyoun I, El-Shaarawy N, Al-Hanafi H, Darwish H, Gamil M, Rasker JJ. In palindromic rheumatism, hand joint involvement and positive anti-CCP antibodies predict RA development after 1 year of follow-up. Clin Rheumatol. June, 2014; 33(6):791-797. https://www.ncbi.nlm.nih.gov/pubmed/24623460.
          3. Descriptions of Diseases. American Autoimmune Related Diseases Association (AARDA). 2017; https://www.aarda.org/descriptions-of-diseases/.
          4. PJW Venables, Ravinder N Maini. Clinical manifestations of rheumatoid arthritis. UpToDate. Waltham, MA: UpToDate; August, 2016; https://www.uptodate.com/contents/clinical-manifestations-of-rheumatoid-arthritis.
          5. Sudeep Thapa, Alireza Meysami. Palindromic Rheumatism: An Unusual Cause of Chronic Intermittent Arthritis. The American Journal of Medicine. December, 2015; 128(12):https://www.ncbi.nlm.nih.gov/pubmed/26235245.