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Remitting seronegative symmetrical synovitis with pitting edema (RS3PE)

RS3PE is a type of benign seronegative polyarthritis that affects older people and is characterised by sudden onset of oedema and swelling of the dorsum of the hands with symmetrical polysynovitis involving wrists, metacarpophalangeal, interphalangeal, tarsal and metatarsophalangeal joints, tenosynovitis of the flexors and extensors of the hands, morning stiffness with negative rheumatoid and anti-nuclear antibody tests and rapid response to low dose corticosteroids. It was first described in 1985 by McCarty et al.

The diagnosis is mainly based on clinical characteristics and by exclusion of other associated conditions.

Blood tests may show raised inflammatory markers (ESR and CRP), normocytic normochromic anaemia, a negative rheumatoid factor and a negative or a low titre for ANA. X-rays of the hands and wrists may show soft tissue swelling in the absence of any erosions. Ultrasound shows tenosynovitis of flexor and extensor tendons. Tenosynovitis of both flexor and extensor tendons at the wrist and the extensor tendons of the feet is a hallmark of RS3PE. MRI can be used for assessing disease activity as it provides information about soft tissue, cartilage and bony erosions.


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Rheumanetz Österreich (German)

BMJ Journals

Archives of Rheumatology

Swiss Medical Forum Article (German)