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Elderly onset rheumatoid arthritis complicated by polymyalgia rheumatica
Haruyo Iwadate1, Isao Takeda, Takashi Kanno
1Division of Rheumatology, Ohta Nishinouchi Hospital, Koriyama.
Internal Medicine (Tokyo, Japan)
|September 5, 2002
Summary
This study presents a case of elderly onset rheumatoid arthritis mimicking polymyalgia rheumatica, highlighting the importance of considering both conditions in elderly patients with severe muscle pain and arthritis.
Area of Science:
- Rheumatology
- Clinical Case Study
Background:
- Elderly onset rheumatoid arthritis (EORA) can present with diverse symptoms.
- Polymyalgia rheumatica (PMR) is characterized by muscle pain and stiffness, typically in the shoulder and pelvic girdle.
Observation:
- A 70-year-old patient presented with EORA, severe shoulder and pelvic girdle muscle pain, erosive polyarthritis, and high rheumatoid factor titers.
- Muscular symptoms including weakness and atrophy emerged one month post-arthritis onset.
- Ultrasonography confirmed synovial effusion and extra-articular soft tissue edema in the knee.
Findings:
- Simultaneous presentation of seropositive erosive arthritis and severe muscle manifestations suggested coexisting EORA and PMR.
- Low-dose prednisolone (20 mg/day) effectively resolved the muscular symptoms.
Implications:
- This case underscores the diagnostic challenge in differentiating EORA from PMR in elderly individuals.
- Prompt recognition and treatment of overlapping EORA and PMR symptoms can significantly improve patient outcomes.
- Consideration of polymyalgia rheumatica in elderly patients with rheumatoid arthritis and significant muscle pain is crucial for accurate diagnosis and management.