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Case Reports in Rheumatology
Volume 2013, Article ID 923797, 3 pages
Case Report

Unilateral RS3PE in a Patient of Seronegative Rheumatoid Arthritis

Division of Rheumatology, Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India

Received 19 February 2013; Accepted 19 March 2013

Academic Editors: T. C. Hsu, M. A. Hunt, K. P. Makaritsis, and A. Zoli

Copyright © 2013 Ankur Nandan Varshney et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare but well-reported clinical entity. It is classically described as symmetrical involvement of both upper extremities. Asymmetrical involvement had also been reported, but unilateral presentation is very rare. We hereby report a case of unilateral RS3PE in a patient of seronegative rheumatoid arthritis which was initially misdiagnosed as cellulitis and was given high dose antibiotics without any significant improvement. Later a rheumatologic consultation leads to a prompt diagnosis, and treatment with steroids leads to dramatic reversal of symptoms. This case demonstrates the rare presentation of this rare clinical entity and highlights the necessity of awareness regarding unilateral disease to clinicians.