Palindromic rheumatism: a reappraisal

Palindromic rheumatism (PR) is characterized by acute, usually monoarticular, arthritis occurring intermittently and lasting for a few days. A significant number of patients with PR develop chronic rheumatic disease, especially rheumatoid arthritis (RA). There remains controversy as to whether PR is a disease entity in itself, or just a preclinical or abortive form of RA. Recently, a high frequency of anticitrullinated peptide/protein antibodies, the most specific biomarkers of RA, have been found in serum from PR patients, further strengthening the link with RA. However, although rheumatoid factor and anticitrullinated peptide/protein antibodies positivity are predictors of progression to RA in PR, a significant number of patients with these autoantibodies do not develop RA after a long follow-up. No controlled clinical trials have been carried out in PR and the treatment and management is still empirical. This review exhaustively analyzes and updates the epidemiological, clinical, diagnostic, prognostic...