Case Report: Syndrome of Remitting Seronegative Symmetrical Synovitis with Pitting Edema-A Rare but Treatable Condition in Palliative Medicine
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Updated: Aug 14, 2025

Synovial Fluid Analysis to Identify Osteoarthritis
Published on: October 20, 2022
L Merkle Moore1, Jennifer M Brouner2, Nelly Grigorian1
1ETSU Quillen College of Medicine, Johnson City, Tennessee, USA.
Abstract:
The syndrome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare diagnosis that is often missed due to lack of both definitive diagnostic criteria and awareness of the disease. This case report describes a patient with chronic lymphocytic leukemia whose diagnosis of RS3PE was possibly delayed due to concomitant treatment-related arthralgias. The pathophysiology, presentation, and treatment of RS3PE are discussed. Greater awareness of malignancy-related RS3PE is crucial from a palliative care perspective as typical opioid pain management will prove ineffective and delay appropriate treatment.
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