Case Report: Syndrome of Remitting Seronegative Symmetrical Synovitis with Pitting Edema?A Rare but Treatable Condition in Palliative Medicine

Abstract

The syndrome of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare diagnosis that is often missed due to lack of both definitive diagnostic criteria and awareness of the disease. This case report describes a patient with chronic lymphocytic leukemia whose diagnosis of RS3PE was possibly delayed due to concomitant treatment-related arthralgias. The pathophysiology, presentation, and treatment of RS3PE are discussed. Greater awareness of malignancy-related RS3PE is crucial from a palliative care perspective as typical opioid pain management will prove ineffective and delay appropriate treatment.

Keywords

• bone pain
• corticosteroids
• palliative medicine
• paraneoplastic
• RS3PE
• synovitis