Turkish Journal of Geriatrics 2013 , Vol 16, Issue 2
COEXISTENCE OF RS3PE AND PSEUDOGOUT
Barış NACIR, Seçil ATASOY, Burcu DUYUR ÇAKIT, Hakan GENÇ
Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi, 2. Fizik Tedavi ve Rehabilitasyon Kliniği ANKARA Pseudogout is an acute inflammatory arthritis associated with intraarticular deposition of calcium pyrophosphate dihydrate crystals. Remitting seronegative, symmetric synovitis with pitting edema (RS3PE) is a benign syndrome that can be seen with rheumatologic and neoplastic diseases. The coexistence of these diseases is a rare condition.

An 68 year-old male patient, was admitted to our outpatient clinic with complaints of severe pain and stiffness in the shoulders and swelling of both hands and feet. He had pitting edema in both hands and feet. Laboratory results were as follows: erythrocyte sedimentation rate; 3 mm/h, rheumatoid factor (RF) level; <20 IU/mL, C-reactive protein; 20.6 mg/dL. Knee radiographs showed calcifications at the lateral aspects of the left knee joint, thoracolumbar graphs showed T11-12 and T12-L1 disc calcifications as well as calcification of outer fibers of annulus fibrosus at L2-L3 level. In the light of clinical, laboratory and radiologic findings, the diagnosis was coexistence of pseudogout and RS3PE. 15 mg/day prednisolone was prescribed. At the third day after therapy, pitting edema of the hands and feet were significantly decreased.

With this case report, we aimed to emphasize the difficulties of differential diagnosis of inflammatory diseases in elderly patients. Keywords : Chondrocalcinosis; Aged; Edema; Syndrome; Synovitis/Diagnosis; Synovitis/Therapy