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Remitting, seronegative, symmetrical synovitis with pitting edema--13 additional cases
E B Russell1, J B Hunter, L Pearson
1Department of Medicine, Medical College of Wisconsin, Milwaukee 53226.
The Journal of Rheumatology
|May 1, 1990
Summary
This study describes a rare, acute synovitis in elderly patients that resolves completely without relapse. Despite full remission, patients often experience residual finger and wrist contractures, distinguishing it from rheumatoid arthritis.
Area of Science:
- Rheumatology
- Clinical Medicine
- Immunology
Background:
- Describes 13 elderly patients with acute, severe synovitis affecting flexor digitorum tendon sheaths and wrists.
- Presents with pitting edema of the hands and is persistently seronegative for rheumatoid factors.
Observation:
- Patients experienced a complete remission without relapse.
- Asymptomatic residual flexion contractures of fingers and wrists were consistently observed during remission.
Findings:
- The condition is distinct from rheumatoid arthritis and polymyalgia rheumatica.
- HLA-B7 antigen was present in 15 of 23 reported cases, indicating a potential genetic association (relative risk = 4.4).
Implications:
- Highlights a distinct rheumatological condition with an excellent prognosis.
- Understanding this condition aids in accurate diagnosis and differentiation from other inflammatory arthropathies.
- Suggests a need for further research into the pathogenesis and genetic factors, including HLA-B7, associated with this synovitis.