- With Mayo Clinic rheumatologist
April Chang-Miller, M.D.
read biographyclose windowBiography of
April Chang-Miller, M.D.
April Chang-Miller, M.D.
Dr. April Chang-Miller is board certified in internal medicine and rheumatology and is a consultant in the Division of Rheumatology and Internal Medicine at Mayo Clinic in Arizona.
Dr. Chang-Miller's primary field is rheumatology with special interests in inflammatory joint diseases called seronegative spondyloarthropathies such as ankylosing spondylitis and psoriatic arthritis. She also cares for patients with rheumatoid arthritis and polymyalgia rheumatica.
The New York City native is a graduate of the Yale University School of Medicine and had been with Mayo Clinic in Rochester, Minn., between 1991 and 2002 when she relocated to Mayo Clinic, Arizona. She is a fellow in the American College of Rheumatology and has been on the board of directors of the Arthritis Foundation North Central Chapter.
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Question
Palindromic rheumatism: Why is treatment so challenging?
Why is palindromic rheumatism so difficult to treat?
Answer
from April Chang-Miller, M.D.
Palindromic rheumatism is characterized by sudden and recurrent attacks of painful swelling of the joints and surrounding tissues. Attacks may last for several days or just a few hours. Between attacks, pain and swelling completely disappear.
Treatment can be challenging because the attacks are so difficult to predict. Although palindromic rheumatism can recur over many years, it doesn't usually cause permanent joint damage. Half the people who have palindromic rheumatism eventually develop rheumatoid arthritis.
Drugs originally designed to combat malaria are often helpful in reducing the frequency and duration of attacks. These drugs also appear to reduce the likelihood that palindromic rheumatism will progress to rheumatoid arthritis.
- Clinical syndromes of early rheumatoid arthritis: Unusual patterns or variants of disease. In: Firestein GS, et al. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa.: W.B. Saunders Co.; 2008. http://www.mdconsult.com/das/book/body/121921806-5/807919840/1807/471.html#4-u1.0-B978-1-4160-3285-4..10066-X--s0100_2327. Accessed Feb. 23, 2009.
- Powell A, et al. Palindromic rheumatism is a common disease: Comparison of new-onset palindromic rheumatism compared to new-onset rheumatoid arthritis in a 2-year cohort of patients. The Journal of Rheumatology. 2008;35:992.
