Ultrasonographic evaluation of knee joint synovitis in two patients with palindromic rheumatism

Abstract

The aim was to evaluate synovial proliferation ultrasonographically in order to identify the period of conversion from palindromic rheumatism to the early-stage of rheumatoid arthritis. Two patients, a 35-year-old man and a 44-year-old man, had been suffering from episodic attacks and remission of oligoarthralgia for 15 years and 6 years, respectively. Both patients were negative for rheumatoid factors, and exhibited slightly elevated levels of C-reactive protein and erythrocyte sedimentation rate at the times of the attacks. Radiograms of the affected joints showed no erosion of the bones in either patient. Ultrasonographic examination revealed both synovial effusion and synovial proliferation in the 35-year-old patient, suggesting conversion from palindromic rheumatism to rheumatoid arthritis, whereas only synovial effusion was found in the 44-year-old patient, suggesting the persistence of palindromic rheumatism. Ultrasonographic evaluations of synovial proliferation in the knee joints provide data that can be used to identify the period of conversion from palindromic rheumatism to the early-stage of rheumatoid arthritis.