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Background  This multicenter incident cohort aimed to characterize how often early rheumatoid arthritis ( ERA ) patients self‐report episodic joint inflammation (palindromic rheumatism) preceding  ERA  diagnosis and which characteristics differentiate these patients from those without prior episodic symptoms.    Methods  Data were from patients with early confirmed or suspected  RA  (more than 6 weeks and less than 12 months) enrolled in the Canadian Early ArThritis CoHort ( CATCH ) between April 2017 to March 2018 who completed study case report forms assessing joint pain and swelling prior to  ERA  diagnosis. Chi‐square and  t  tests were used to compare characteristics of patients with and without self‐reported episodic joint inflammation prior to  ERA  diagnosis. Multivariable logistic regression was used to identify sociodemographic and clinical measures associated with past episodic joint inflammation around the time of  ERA  diagnosis.    Results  A total of 154  ERA  patients were included; 66% were female, and mean (SD) age and  RA  symptom duration were 54 (15) years and 141 (118) days. Sixty‐five (42%)  ERA  patients reported a history of episodic joint pain and swelling, half of whom reported that these symptoms preceded  ERA  diagnosis by over 6 months.  ERA  patients with past episodic joint inflammation were more often female, had higher income, were seropositive, had more comorbidities, fewer swollen joints, and lower Clinical Disease Activity Index ( CDAI ) around the time of  ERA  diagnosis ( P  < 0.05). These associations remained significant in multivariable regression adjusting for other sociodemographic and  RA  clinical measures.    Conclusion  Almost half of  ERA  patients experienced episodic joint inflammation prior to  ERA  diagnosis. These patients were more often female, had higher income, and presented with milder disease activity at  ERA  diagnosis.

Palindromic Rheumatism Frequently Precedes Early Rheumatoid Arthritis: Results From an Incident Cohort