Remitting Seronegative Symmetric Synovitis With Pitting Edema

September 14, 2005
F. Hall Reynolds II, MD

,
William F. Keenan, MD

Abrupt onset of symmetric inflammatory arthritis and edema, as seen on the dorsum of this 72-year-old man's hand, is characteristic of remitting seronegative symmetric synovitis with pitting edema-or RS3PE. The work-up of this patient was essentially negative for other types of inflammatory arthritides.

Abrupt onset of symmetric inflammatory arthritis and edema, as seen on the dorsum of this 72-year-old man's hand, is characteristic of remitting seronegative symmetric synovitis with pitting edema-or RS3PE. The work-up of this patient was essentially negative for other types of inflammatory arthritides.

This disorder usually is seen in older men, and its cause is unknown. In addition to having dorsal hand swelling and pitting edema, persons with RS3PE may have wrist synovitis, flexor tendinitis of the fingers, and similar swelling and synovitis of the feet and ankles.

This patient's symptoms responded to various NSAIDs and diuretics. Low-dose prednisone was added to the regimen because the edema worsened with high-dose NSAID use. The arthritis remitted after 3 years and has not recurred for 2 years.