Table 1 Clinical findings in remitting seronegative symmetrical synovitis with pitting edema, polymyalgia rheumatica, and calcium pyrophosphate (CPP) crystal arthritis [2, 4,5,6, 10, 11]
Disease | RS3PE | PMR | CPP arthritis |
|---|---|---|---|
Age (years) | Typically > 50 | Over 60 | typically > 60 |
Sex | Male > female | Female > male | = |
Symptom onset | Sudden | Progressive | Sudden or progressive |
Pitting edema (hands and feet) | Common, symmetrical | − | − |
Synovitis small articulations | ++ | + (30%) | + |
Shoulder and pelvic girdle pain/stiffness | +/− | +++ | + |
Functional impact | High | Moderate | Moderate |
Radiological erosions | − | − | − |
Elevation of CRP, ESR | + | ++ | + |
RF | Negative (100%) | Negative/positive (16%) | Negative (100%) |
Anti-CCP antibodies | Negative | Negative/positive | Negative |
Genetic factors | HLA B7 (55%) | HLA DR4 | ANKH gene mutation |
Response to corticoid therapy | High, spectacular | High | High |
Treatment duration | Short, several weeks/months | 2−3 years | Variable |
Relapse | Rare | Common within 2 years after diagnosis | Frequent |
Paraneoplastic syndrome | 20% | 2.4% | No |
Up to 30% if association of RS3PE and PMR To be considered if resistant to glucocorticoids | |||