RS3PE

Full Papers; Authors: Paras Karmacharya, Anthony A. Donato, Madan R. Aryal, Sushil Ghimire, Ranjan…
www.clinexprheumatol.org
RS3PE stands for Relapsing/Remitting Seronegative Symmetrical Synovitis with Peripheral Edema. It’s like Rheumatoid Arthritis without rheumatoid factor, or a worse case of Palindromic Rheumatism in the elderly, with puffiness in the hands and feet. There is an association with malignancy. More males than females are affected, the opposite of RA. Response is best to higher dosages of steroids.
Apart from the malignancy link (which may be more a function of age rather than a direct causal relationship), IT SOUNDS VERY MUCH LIKE GOUT! Given my recent Gout epiphany, I would undertake an exhaustive exclusion of Gout with ultrasound, DECT scan, blood uric acid level, and joint aspiration for urate crystals before invoking RS3PE. It is far less common than Gout by a mile, and remember the adage that “common things occur more commonly”!