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We read the article by Mankia et al on the distinct ultrasound (US) imaging phenotype in palindromic rheumatism (PR) with great interest.1 The authors found characteristic US findings in PR during flares that differ from those observed in patients with early rheumatoid arthritis (RA) or anti-cyclic citrullinated peptide (CCP)+ arthralgia. US extracapsular inflammation (periarticular inflammation, subcutaneous or peritendinous oedema), in most cases without joint synovitis, is the most frequent US finding in PR. These findings disappeared after acute attacks. The authors concluded that this imaging phenotype of extracapsular inflammation is specific for PR and may be distinguished from that observed in RA or persistent arthritis. They also suggest that true US intrasynovial inflammation may predict future RA in these patients. …
Handling editor Josef S Smolen
Contributors RS and SC-V designed the study. JR performed the ultrasound study. All the coauthors contributed to acquisition of data and manuscript writing.
Funding Please change: This study was supported by a grant from the Hospital Clínic of Barcelona (Sonia Cabrera-Villalba, Premi Fi de residencia: Emili Letang 052012)
Competing interests None declared.
Patient consent for publication Obtained.
Ethics approval Ethics Comitee of Hospital Clinic.
Provenance and peer review Not commissioned; internally peer reviewed.
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