Palindromic Rheumatism: Longterm Outcomes of 60 Patients Diagnosed in 1967-84

Objective. To study longterm outcomes of 60 patients with palindromic rheumatism (PR) diagnosed in 1967-1984. Methods. A cohort of patients with PR was identified in Jyvaskyla Central Hospital in 1967-84, and reexamined in 1984-86. In 2006, medical records of the patients were reviewed to analyze the proportion of patients who had developed chronic rheumatoid arthritis (RA), had joint replacement surgery, or had died. Patients' health status was reviewed by mail questionnaires including functional status on the Health Assessment Questionnaire (HAQ), pain, and the number of painful joints. Results. Forty patients developed chronic RA over the observation period of over 20 years, among whom 38 patients within 10 years and 2 patients after 10 years. Twenty-four patients had died by 2006, 17 (42%) in the RA group and 7 (35%) in the non-RA group. Nine patients, all in the RA group (23%), had received I or more joint replacements. The mean HAQ score was 0.57 in the non-RA survivors (mean age 70 yrs), compared to 0.89 in the RA group (mean age 66 yrs) (p=0.020, adjusted for age). Pain scores and the number of painful joints were similar between the groups. Conclusion. Two-thirds of the patients with PR developed chronic arthritis. The risk to develop chronic arthritis remained over 10 years. The RA group was characterized with functional declines and having joint replacements as longterm outcomes of the disease. (First Release Aug 1 2009; J Rheumatol 2009 36:1873-5; doi: 10.3899/jrheum.090025)