Cause
The cause is unknown but allergic and auto-inflammatory mechanisms have been proposed.In a 1957 review of IH, Mattingly did not find evidence that the condition is inherited unlike Reimann who, in 1974, describes the condition as “heritable, non-inflammatory, and afebrile”.More recently, specific association with the Mediterranean fever gene, MEFV, has been proposed. So, with some individuals carrying gene mutations (MEFV and also TRAPS-related genes), the native immune system seems to plays a role in the development of IH, i.e. there is an auto-immune component to the condition. Pathophysiology
Involvement of mast cells has been reported  reflecting a possible immunoallergic aspect to IH. Mattingly suggests that IH may be an unusual variant of rheumatoid arthritis, and some patients may go on to develop RA. Joint damage however does not generally occur and only the synovial membrane is affected by a ‘non-inflammatory oedema’.With regard to the periodic nature of effusions, Reimann theorises that:
“…either an inherent rhythm or a feedback mechanism (Morley, 1970) excites bioclocks in the hypothalamus or in the synovial membrane (Richter, 1960). These Zeitgebers provoke sudden accumulation of plasma in the lining and spaces of joints, tendon and ligament sheaths.”

Diagnosis
There is no specific test for this condition. Diagnosis is based on signs and symptoms, and exclusion of other conditions. Differential diagnoses
Rheumatoid arthritis. Confusion with rheumatoid arthritis may be common even though IH is a non-inflammatory condition without the many signs and symptoms associated with RA. So far, an association with HLA-B27 gene in IH has not been reported.
Oxytocin is also used in veterinary medicine to facilitate birth and to stimulate milk release. The tocolytic agent atosiban (Tractocile) acts as an antagonist of oxytocin receptors. It is registered in many countries for use in suppressing premature labor between 24 and 33 weeks of gestation. It has fewer side effects than drugs previously used for this purpose (such as ritodrine, salbutamol and terbutaline).Oxytocin has not been found to be useful for improving breastfeeding success. Contraindications
Oxytocin injection (synthetic) is contraindicated in any of these conditions:
Substantial cephalopelvic disproportion
Unfavorable fetal position or presentation (e.g., transverse lies) undeliverable without conversion before delivery
Obstetric emergencies where maternal or fetal risk-to-benefit ratio favors surgery
Fetal distress when delivery is not imminent
Umbilical cord prolapse
Uterine activity fails to progress adequately
Hyperactive or hypertonic uterus
Vaginal delivery is contraindicated (e.g., invasive cervical carcinoma, active genital herpes infection, total placenta previa, vasa previa, cord presentation or prolapse)
Uterine or cervical scarring from previous cesarean section or major cervical or uterine (e.g., transfundal) surgery
Unengaged fetal head
History of hypersensitivity to oxytocin or any ingredient in the formulation

Side effects
Oxytocin is relatively safe when used at recommended doses, and side effects are uncommon. These maternal events have been reported:
Subarachnoid hemorrhage
Increased blood pressure
Cardiac arrhythmia including increased or decreased heart rate, and premature ventricular contraction
Impaired uterine blood flow
Pelvic hematoma
Afibrinogenemia
Anaphylaxis
Nausea and vomiting
Increase fetal blood flowExcessive dosage or long-term administration (over a period of 24 hours or longer) has been known to result in tetanic uterine contractions, uterine rupture, postpartum hemorrhage, and water intoxication, sometimes fatal.