M12.36

Clinical Causes: The exact cause of palindromic rheumatism remains unknown, but it is believed to involve immune system dysfunction. Genetic factors may predispose individuals to developing this condition. Environmental triggers such as infections have been suggested as potential catalysts for attacks. Autoimmune mechanisms are thought to play a central role, with the immune system mistakenly attacking joint tissues during episodes.

Key Symptoms: Sudden onset of pain in the knee joint Swelling and warmth around the affected knee Redness of the skin over the joint Joint stiffness, especially after periods of inactivity Episodes lasting from a few hours to several days, with symptoms resolving completely between attacks Possible sensations of crepitus or grinding in the joint during episodes In some cases, mild fever or general malaise may occur alongside joint symptoms

Diagnosis Path: Clinical evaluation of symptoms, including the pattern of episodic joint swelling and pain Physical examination focusing on the knee for signs of inflammation Blood tests to rule out other rheumatic diseases, such as rheumatoid arthritis or gout Imaging studies like X-rays may be used to assess joint damage or inflammation, but often show normal findings during attacks Synovial fluid analysis can help exclude infections or crystalline diseases

Treatment Protocols: Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation during attacks Disease-modifying antirheumatic drugs (DMARDs), sometimes used in persistent or severe cases Rest and joint protection strategies to prevent stress on the knee Physical therapy to maintain joint function and strength Monitoring for progression to other rheumatic conditions, such as rheumatoid arthritis Lifestyle modifications, including weight management, to decrease joint load In some cases, corticosteroid injections may be considered for severe inflammation