You may have palindromic rheumatism because you have symptoms only sometimes...ASO titre only indicates infection with Streptococcal bacteria in the last 6 months (simple sore throat/nasopharyngitis/skin infection) and may not be of significance.Please do consult your nearest Rheumatologist. Palindromic rheumatism is a rare type of inflammatory arthritis. Symptoms are often mistaken for rheumatoid arthritis symptoms. There are distinguishing features between palindromic rheumatism and rheumatoid arthritis and it is important to recognize the difference. Palindromic Rheumatism: What You Should Know As a rare type of inflammatory arthritis with distinctive features, palindromic rheumatism is sometimes referred to as a syndrome. A syndrome is defined as a collection of symptoms. Palindromic rheumatism is characterized by episodes or attacks of pain and swelling of the joints, as well as tissues that surround the joints. Attacks of palindromic rheumatism usually involve one to three joints. Attacks of palindromic rheumatism start suddenly and last for hours or days before spontaneous remission occurs. Attacks recur but with unpredictable frequency. Some doctors and patients have recognized that patterns begin to develop. Palindromic rheumatism does not usually lead to permanent joint damage, unlike rheumatoid arthritis. This is one of the major differences between the two diseases. Approximately 30-40 percent of palindromic rheumatism patients develop more frequent episodes or attacks over time. They may later develop rheumatoid arthritis and theirrheumatoid factor may become positive. The most commonly involved joints with palindromic rheumatism include: large joints,knees, and fingers. Subcutaneous nodules may also develop in palindromic rheumatism patients but the nodules are different in some ways from those seen in rheumatoid arthritis patients. The palindromic rheumatism patient may or may not have a fever, and may have elevatedsedimentation rate or C-reactive protein during attacks. X-rays are normal in patients with palindromic rheumatism as joint space narrowing is not present as it is in rheumatoid arthritis...do consult a Rheumatologist