National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Palindromic rheumatism



Other Names:
Palindromic rheumatism syndrome; Hench-Rosenberg syndrome; Hench's syndrome
Categories:

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]
Last updated: 2/28/2017

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Patient Registry

  • The Autoimmune Registry supports research for Palindromic rheumatism by collecting information about patients with this and other autoimmune diseases. You can join the registry to share your information with researchers and receive updates about participating in new research studies. Learn more about registries.

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


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.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.


  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.