Remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome)

A 63-year-old man presented with acute symmetrical polysynovitis associated with pitting edema of both the hands and feet. He was seronegative for rhe umatoid factor and no radiologically evident erosion was noted in the joint s of his hands and feet. Evaluation excluded congestive heart allure, nephr otic syndrome, and hypothyroidism as the cause of edema. Treatment with non steroidal anti-inflammatory drugs and low-dose steroids induced complete re mission. The clinical manifestations of this patient were consistent with t hose of a distinctive, although rare, form of arthritis called remitting se ronegative symmetrical synovitis with pitting edema (RS3PE) syndrome. This syndrome has a good prognosis in elderly patients.