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How is palindromic rheumatism diagnosed?

Palindromic rheumatism is very rare, so your GP may not have seen many cases. It can sometimes be confused with conditions like rheumatoid arthritis, where early treatment is vital to prevent joint damage. Because of this, your GP should refer you to a specialist rheumatologist to confirm your diagnosis.

There's no specific test for palindromic rheumatism so a diagnosis is based on your symptoms. Your doctor may also ask questions and examine you to help rule out other forms of inflammatory arthritis like rheumatoid arthritis or gout. It may help if they can examine you during an attack because symptoms disappear once the attack has finished.

Taking a photo of the affected joints during an attack may be helpful. If the picture is good enough, it may help your doctor make a diagnosis.

Once the diagnosis has been confirmed, you’re likely to be looked after in a shared care system by your GP and a specialist rheumatologist (possibly with a rheumatology nurse specialist). They’ll need to monitor your condition to make sure you're not developing an ongoing form of inflammatory arthritis like rheumatoid arthritis, as this would need more intensive treatment.

What tests are there?

Blood tests like the erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP) can show raised levels of inflammation in your body during an attack. Other blood tests can check for antibodies such as rheumatoid factor, anti-CCP antibodies and anti-nuclear antibodies.

X-rays of affected areas will be normal as palindromic rheumatism doesn't damage your joints.

For more information, go to www.arthritisresearchuk.org.
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