Palindromic Rheumatism: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Palindromic Rheumatism?
A rheumatologist, a doctor who treats joint and immune system diseases, usually confirms and treats palindromic rheumatism. Your regular doctor may check for other causes first and then refer you. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is palindromic rheumatism?
Palindromic rheumatism is a rare type of inflammatory arthritis. Arthritis means joint pain and swelling. It causes sudden attacks of joint pain and swelling that come and go. It is sometimes called palindromic arthritis.
Between attacks, the joints look and feel normal. The attacks are not thought to cause lasting damage to the joints.
Symptoms
During an attack, the joints can hurt, feel stiff, and look swollen. Common features include:
- Sudden pain and swelling in one or a few joints, with redness in some cases.
- Attacks usually start in one or two joints, often in the hands.
- Attacks that can move from joint to joint.
- Attacks that last from several hours to several days.
- Tiredness after an attack, and a fever in some people.
How often attacks happen is different for everyone. Some people have less than one attack a year. Others have them more than once a week.
Causes and who gets it
Doctors do not yet know what causes the inflammation in palindromic rheumatism. The immune system, the body's defense system, attacks the joints by mistake. There may be genetic links, and triggers such as infection, hormones, or injury may play a part.
It affects women and men equally. It can start at any age, but it rarely affects children.
Some people with palindromic rheumatism later develop rheumatoid arthritis, a long-term joint disease that can damage joints. This is more likely in people whose blood tests show rheumatoid factor or anti-CCP antibodies. Very rarely, a person develops lupus, another immune system disease.
How doctors diagnose it
No single test can diagnose palindromic rheumatism. A doctor asks about your symptoms and examines your joints. Ideally, a doctor sees you during an attack, before the symptoms go away. A photo of the joints and a diary of your symptoms can help.
Blood tests can check for inflammation, which is swelling and irritation in the body. Other blood tests look for antibodies, which are immune system proteins. Doctors may order x-rays to rule out other conditions. The condition can be confused with gout and rheumatoid arthritis.
Treatment
Care is often shared between your regular doctor and a rheumatologist. Treatment may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), medicines that ease pain, stiffness, and swelling during attacks. They can sometimes cause side effects, such as stomach problems, so ask your doctor how to take them safely.
- Steroid injections, which a doctor may suggest if the joints are very painful. They usually work within a few days.
- Disease-modifying anti-rheumatic drugs (DMARDs), such as hydroxychloroquine and sulfasalazine. They can reduce how often attacks happen and how long they last. They may also make it less likely that the condition turns into rheumatoid arthritis.
Balancing activity and rest, eating a nutritious diet, and following your treatment plan can also help.
When to see a doctor
See a doctor if you have sudden joint pain and swelling that keeps coming and going. Getting a diagnosis early means treatment can start as soon as possible. If you can, see the doctor during an attack. Your doctor will keep watching for signs of another condition that needs different treatment.
Get medical care right away if one joint suddenly becomes very painful and you cannot move it or put weight on it, especially with a high temperature or feeling unwell. This can be septic arthritis, a joint infection that needs treatment as soon as possible.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type of doctor can review your symptoms, order blood tests, and refer you to a rheumatologist. They can also follow your health between attacks.
Common questions
Does palindromic rheumatism damage the joints?
No, the attacks are not thought to cause lasting damage to the joints. Rheumatoid arthritis can cause permanent damage, so doctors keep watching for it.
Can palindromic rheumatism turn into rheumatoid arthritis?
Yes, in some people it can. This is more likely if blood tests show rheumatoid factor or anti-CCP antibodies. A positive test does not mean you will definitely develop rheumatoid arthritis.
Is there one test for palindromic rheumatism?
No, no single test can diagnose it. Doctors use your symptoms, an exam, blood tests, and sometimes x-rays.
How long does an attack last?
An attack may last from several hours to several days. Between attacks, the joints return to normal.
Does palindromic rheumatism affect men or women more?
It affects women and men equally.
Sources
- Arthritis Foundation - Palindromic Rheumatism
- Arthritis UK - Palindromic rheumatism
- NHS - Septic arthritis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
