We report the case of a 70 year old white man with rapid onset edema of the four extremities without any other systemic symptoms. Cardiac failure, nephrotic syndrome and hepatic dysfunction were ruled out. Rheumatoid factor was slightly elevated at 33 UI/ml and sedimentation rate was within normal range. Ultrasound examination of the upper limb revealed increased blood flow (400 ml/min) at the level of the brachial artery and edema of the tenosynovial sheaths. A diagnosis of remitting seronegative symmetrical synovitis and pitting edema (RS3PE) was made and prednisone 15 mg/day was prescribed with rapid disappearance of the edema and reduction of the forearm blood flow.