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RS3PE — SCE Rheumatology MCQ

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HardPregnancy in Rheumatic Disease, Rare ConditionsRS3PESCE Rheumatology

A 78-year-old develops acute symmetrical hand and wrist synovitis with pitting oedema over both dorsums. RF and anti-CCP are negative, ultrasound shows extensor tenosynovitis and radiographs show no erosions. What is the diagnosis?

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Correct answer: B — Remitting seronegative symmetrical synovitis with pitting oedema

The acute, symmetric distal synovitis, striking dorsal pitting oedema, seronegativity, tenosynovitis and non-erosive imaging define RS3PE. Malignancy and alternative inflammatory or oedematous disorders should still be considered in an older adult.

Reference: Rheumatology review: RS3PE in the clinical spectrum of polymyalgia rheumatica (Published October 2024): https://academic.oup.com/rheumatology/article/64/2/470/7824070; Rheumatology Advances in Practice: imaging atlas including RS3PE (Published February 2024): https://academic.oup.com/rheumap/article/8/1/rkae003/7610168