Remitting Seronegative Symmetric Synovitis with Pitting Edema (RS3PE) Dx

Definition: Remitting inflammatory arthritis of hands and feet affecting primarily the elderly. The etiology is unknown. One-half of patients are HLA-B7 positive.

Demographics: Older males, >50 years of age, are predominantly affected.

Cardinal Findings: Abrupt onset of marked dorsal swelling of the hands (or feet) with pitting edema, wrist synovitis, and flexor finger tendinitis. Most cases remit in a year; fewer cases develop into RA, SpA, or malignancy.

Therapy: Good response to low-dose prednisone, NSAID, or hydroxychloroquine therapy.

BIBLIOGRAPHY

Finnell JA, Cuesta IA. Remitting seronegative symmetrical synovitis with pitting edema(RS3PE)syndrome: a review of the literature and a report of three cases. J Foot Ankle Surg. PMID:10862391