Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema

Ünlü, Zeliha; Örgüç, Şebnem; Ovalı, Gülgün Yılmaz; Tarhan, Serdar; Dayan, Idris; Angın, Aclan

doi:10.1007/s10067-005-1127-4

Cited by 12 publications

(7 citation statements)

References 13 publications

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“…We have investigated this hypothesis more intensely in the present case by serologic variables and radiographic methods. These abnormalities have been reported previously [3][4][5][6][7][8][9]; however, this is a first report of a patient showing recovery of all these parameters at once after treatment. In vitro studies have revealed that IL-6 induces the production of VEGF [10], MMP-3 [11], and SAA [12].…”

Section: Discussionsupporting

confidence: 72%

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Monitoring of therapeutic efficacy in a patient with RS3PE syndrome by serologic variables and radiographic methods

et al. 2009

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We experienced a typical patient with remitting seronegative symmetrical synovitis with pitting edema (RS 3 PE) syndrome and describe here a successful clinical course monitored by serologic variables and radiographic methods.Serum levels of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), matrix metalloproteinase-3 (MMP-3), and serum amyloid A (SAA) were remarkably elevated.Accumulation of inflammatory cells into the multiple joints was found by Gallium-67 scintigraphy.Multiple and symmetrical tenosynovitis with hypervascularity in the presence of subcutaneous edema of the hands and feet were determined by magnetic resonance imaging (MRI) and ultrasonography. These serologic and radiographic abnormalities immediately improved after treatment with a low-dose steroid.Our present case supports a previous observation that synovial tissue is a major inflammatory source of RS 3 PE syndrome. IL-6 (and VEGF), probably produced from the synovial tissues, are considered to be essential factors in the development of RS 3 PE syndrome.

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Section: Discussionsupporting

confidence: 72%

“…We previously reported that the serum level of vascular endothelial growth factor (VEGF) was markedly elevated in patients with RS 3 PE syndrome [3]. As diagnostic imaging tools, magnetic resonance imaging (MRI), ultrasonography (USG), and Gallium (Ga)-67 scintigraphy are useful for the detection of inflammatory sites [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Monitoring of therapeutic efficacy in a patient with RS3PE syndrome by serologic variables and radiographic methods

et al. 2009

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“…6 Besides, magnetic resonance imaging revealed symmetrical subcutaneous edema and tenosynovitis in flexor tendon sheath. 7 After steroid therapy, edema and tenosynovitis might resolve completely. 7 Among these patients, 59% of them had HLA-B27 positivity in contrast to 24% in the general population, 8 but no causal relationship can be established yet.…”

Section: Discussionmentioning

confidence: 99%

“…7 After steroid therapy, edema and tenosynovitis might resolve completely. 7 Among these patients, 59% of them had HLA-B27 positivity in contrast to 24% in the general population, 8 but no causal relationship can be established yet. Moreover, biopsy proved that autoimmune hepatitis had been reported to be related to RS3PE syndrome.…”

Section: Discussionmentioning

confidence: 99%

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: A case report

Chen

Hwang

Chen

et al. 2011

Journal of Clinical Gerontology and Geriatrics

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a b s t r a c tRemitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare form of paraneoplastic tenosynovitis, which is more prone to occur in elderly males. A 78-year-old male had a past history of gastric cancer 23 years ago and underwent subtotal gastrectomy then. He led a fair life after the surgery. However, fever, edema in four extremities, gait disturbance, and liver function impairment bothered him for 5 months, which caused significant physical functional decline. Despite of extensive laboratory and imaging examinations, no definite diagnosis and treatment were provided. He was referred to Kyoto University hospital and RS3PE was diagnosed. After the diagnosis of RS3PE syndrome was made, systemic steroid was given and fever, edema and liver function impairment improved dramatically within 7 days. The patient was well managed by oral prednisolone 30 mg per day after discharge. RS3PE should be considered when an elderly man with aforementioned presentations in order to prevent significant functional decline in daily living.

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“…6 Recently, Magnetic resonance imaging (MRI) has been reported to be a sensitive diagnostic measure of evaluation of predominant involvement of the extensor tendons in RS3PE, showing symmetrical subcutaneous edema and increased vascularity of the synovium as well as contrast enhancement of the synovial proliferation. 7,8 MRI is also useful for monitoring the disease activity in RS3PE syndrome. On the other hand, Agarwal V et al proposed ultrasonography as another diagnostic tool.…”

Section: Discussionmentioning

confidence: 99%

A Case with Fever and Multiple Joint Pain

Okada

Shimizu

2014

Gen. Med.

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Magnetic resonance imaging findings in a case of remitting seronegative symmetrical synovitis with pitting edema

Abstract: We describe a case of remitting seronegative symmetrical synovitis with pitting edema (RS3PE syndrome) in a 66-year-old man. This report discusses magnetic resonance imaging findings of RS3PE syndrome and the changes after steroid therapy.

Cited by 12 publications

References 13 publications

Monitoring of therapeutic efficacy in a patient with RS3PE syndrome by serologic variables and radiographic methods

Monitoring of therapeutic efficacy in a patient with RS3PE syndrome by serologic variables and radiographic methods

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: A case report

A Case with Fever and Multiple Joint Pain

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