Abstract
Remitting Seronegative Symmetrical Synovitis with Pitting oedema syndrome, a rare inflammatory arthritis, commonly affects people in the older age group. It can present as an acute onset polyarthritis with associated pitting oedema of the extremities. Patients show excellent response to low dose steroids with complete and sustained remissions. It can also be a paraneoplastic manifestation of an underlying occult malignancy, hence thorough clinical evaluation is warranted.We discuss a case of Remitting Seronegative Symmetrical Synovitis with pitting oedema syndrome where the patient presented with acute onset polyarthritis and pitting oedema of the extremities without an underlying systemic cause. Patient showed dramatic response to low dose steroids.
Highlights
Remitting Seronegative Symmetrical Synovitis with Pitting oedema (RS3PE) syndrome, a subset of acute onset polyarthritis mainly affects the older people and predominantly males with clinical manifestations of acute onset pitting oedema of the hands
In 1985, McCarty et al [1] described the first case of Remitting Seronegative Symmetrical Synovitis with Pitting Oedema (RS3PE) syndrome characterized by symmetrical distal synovitis and tenosynovitis of the mucous sheaths of the flexor and extensor tendons of the hands associated with pitting oedema of the hands and/or feet
In this case report we discuss a case of Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome where the initial presentation was bilateral pitting oedema of the extremities without any other systemic cause
Summary
Remitting Seronegative Symmetrical Synovitis with Pitting oedema (RS3PE) syndrome, a subset of acute onset polyarthritis mainly affects the older people and predominantly males with clinical manifestations of acute onset pitting oedema of the hands. In 1985, McCarty et al [1] described the first case of Remitting Seronegative Symmetrical Synovitis with Pitting Oedema (RS3PE) syndrome characterized by symmetrical distal synovitis and tenosynovitis of the mucous sheaths of the flexor and extensor tendons of the hands associated with pitting oedema of the hands and/or feet. A 67-year-old male Caucasian patient was admitted with a 2-week history of painful swollen hands and painful knees associated with worsening mobility This was preceded by a history of swinging low-grade pyrexia for two months and a history of progressive pedal oedema for 4 months. Further follow up 8 weeks later on tapering dose of prednisolone showed complete resolution of signs and symptoms without any further flare-ups
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