Distal extremity swelling with pitting edema in ankylosing spondylitis: A case report

Abstract

We described a 70-year-old woman with a 20 years history of ankylosing spondylitis(AS) who developed a puffy right hand. Examination showed diffuse puffiness with pitting edema over the dorsum of her right hand. She was treated with prednisone 30mg/ day and responded dramatically. A slower tapering of the daily dose was tolerated without flare. After several months, the drug was stopped completely without return of symptoms. Our case showed most of the characteristic features of the remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome, only asymmetry differentiates from patients with the pure RS3PE syndrome in our patient. Our report suggests that synovitis with pitting edema may also occur in elderly patients with longstanding AS. Therefore, clinicians should be aware of the possible association of the two diseases.