Because Expertise Matters
Join Cyberounds®, an online education community for health professionals Sign Up

Log In

Palindromic Rheumatism

A 40-year-old female presents with a complaint of right knee pain and swelling for two days. Her symptoms started suddenly. All her other joints are normal. She has been having...
CME credit is no longer available for this conference.

Course Authors

Sahitya Mallipeddi, M.D., Raghu Maddela, M.D., and Peter Barland, M.D.

Drs. Mallipeddi and Maddela are Residents in Internal Medicine, Bronx Lebanon Hospital, Bronx, NY, and Dr. Barland is Professor of Medicine (emeritus), Albert Einstein College of Medicine, Bronx, NY.

Within the past 12 months, Drs. Mallipeddi, Maddela and Barland report no commercial conflicts of interest.

Albert Einstein College of Medicine, CCME staff and interMDnet staff have nothing to disclose.

Estimated course time: 1 hour(s).

Albert Einstein College of Medicine – Montefiore Medical Center designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In support of improving patient care, this activity has been planned and implemented by Albert Einstein College of Medicine-Montefiore Medical Center and InterMDnet. Albert Einstein College of Medicine – Montefiore Medical Center is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Learning Objectives

Upon completion of this Cyberounds®, you should be able to:

  • Describe the clinical picture of palindromic rheumatism

  • Distinguish palindromic rheumatism from other forms of acute monoarticular arthritis

  • Apply the guidelines for the treatment of palindromic rheumatism.



The opinions expressed herein are those of the authors and do not necessarily represent the views of the sponsor or its publisher. Please review complete prescribing information of specific drugs or combination of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.


Please click below to accept the terms of this CME activity

Courses You Might Like

Treatment of Idiopathic Inflammatory Myopathy

Other than glucocorticoids and Acthar, the FDA has not approved any medications for the treatment of myositis. The idiopathic inflammatory myopathies (IIMs) are a group of heterogeneous, systemic rheumatic diseases that include adult polymyositis (PM), adult dermatomyositis (DM), myositis associated with other systemic autoimmune rheumatic diseases or cancer, juvenile myositis (juvenile dermatomyositis and juvenile polymyositis), inclusion body myositis (IBM) and necrotizing autoimmune myopathy. Because of their low incidence and prevalence, their variable clinical phenotypes and the small number of randomized,
Authors: Siamak Moghadam-Kia, M.D., Rohit Aggarwal, M.D. and Chester V. Oddis, M.D.
Estimated Time: 1 Hour

Idiopathic Inflammatory Myopathies: A 2016 Update

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of autoimmune diseases, primarily affecting the skeletal muscles, which cause predominant proximal muscle weakness. The four main types of IIM are dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and a relative newcomer — immune mediated necrotizing myopathy (IMNM). The diagnosis of IIM typically begins with a careful assessment of the pattern of weakness, electromyography, MRI of the muscles when available and muscle biopsy, particularly in cases when a diagnostic skin rash
Authors: Julie J. Paik, M.D.. M.H.S. and Lisa Christopher-Stine, M.D., M.P.H.
Estimated Time: 1 Hour

The Current Treatment of Lupus Nephritis

Lupus nephritis (LN) is a dreaded complication of systemic lupus erythematosus (SLE). One in six patients with SLE will have evidence of kidney involvement at the time of diagnosis and at least 40-75% patients will develop nephritis in the course of their SLE. Lupus nephritis continues to significantly affect morbidity and mortality. Both in the U.S. and in Europe, non-Caucasians have increased rates of nephritis. In the U.S., risk factors for progression to end-stage renal
Authors: Saakshi Khattri, M.D., and Peter Barland, M.D
Estimated Time: 1 Hour

Immunoglobulin G4-related Sclerosing Syndrome

Immunoglobulin G4-related sclerosing syndrome (IgG4 RSS) is a newly recognized systemic clinicopathological entity. It is characterized by chronic inflammation and multiorgan involvement secondary to tissue infiltration with IgG4 secreting lymphoplasmocytic cells. It is also known for its dramatic response to steroids. The recent identification of IgG4 in the affected tissues of many chronic inflammatory syndromes has led to the recognition of a new clinicopathological entity — IgG4 RSS. Prior to the discovery of IgG4 RSS as a multiorgan disorder, many
Authors: Peguy Saad, M.D., and Peter Barland, M.D.
Estimated Time: 1 Hour

Hemophagocytic Syndrome in Rheumatic Diseases

AH, a 23-year-old male, was admitted to our institution with five days of fever, abdominal pain and non-bloody diarrhea. He was febrile to 101.2°F, and his exam revealed a benign abdomen and no rash, lymphadenopathy or synovitis. He was found to be pancytopenic with a WBC of 2600/mm3, an absolute neutrophil count of 1700/mm3, a hemoglobin of 8.9 gm/dL and platelets of 22,000/mm3 with schistocytes seen on the peripheral blood smear. His International Normalized Ratio (INR) was increased at
Authors: Arlene Tan Tieng, M.D., Irene Blanco, M.D., and Peter Barland, M.D.
Estimated Time: 1 Hour

A Critical Review of the Role of Vitamin D Deficiency in Autoimmune Diseases

Vitamin D receptor has been identified on various cells of the immune system including dendritic cells, mononuclear cells, antigen presenting cell and activated B and T lymphocytes. In vitro, addition of vitamin D was shown to decrease antibody production and secretion by B lymphocytes. It also has been shown to inhibit the differentiation of monocytes into immature dendritic cells. Vitamin D also plays a role in dendritic cell maturation and survival by maintaining the immature dendritic cell
Authors: Anna Broder, M.D., and Peter Barland, M.D.
Estimated Time: 1 Hour