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[Inflammatory rheumatic diseases in old age]

K L Schmidt

    Zeitschrift Fur Rheumatologie
    |March 1, 1982
    PubMed
    Summary

    In older adults, inflammatory rheumatic diseases present diagnostic challenges, with polymyalgia rheumatica and chondrocalcinosis being common. Late-onset rheumatoid arthritis can be aggressive and mimic other serious conditions.

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    Rheumatology (Oxford, England)·2004

    Area of Science:

    • Rheumatology
    • Geriatrics
    • Internal Medicine

    Context:

    • Degenerative spinal and joint diseases are common in older adults.
    • Inflammatory rheumatic diseases, though less prevalent than degenerative conditions, pose significant diagnostic challenges in the elderly.
    • Certain rheumatic diseases have a milder course in older individuals compared to younger age groups.

    Purpose:

    • To highlight the diagnostic complexities of inflammatory rheumatic diseases in the elderly.
    • To differentiate typical age-related rheumatic conditions from those with late-onset presentation.
    • To emphasize the potential severity and diagnostic pitfalls of late-onset rheumatoid arthritis in seniors.

    Summary:

    • While degenerative conditions dominate in older populations, inflammatory rheumatic diseases are relatively common and diagnostically challenging.
    • Rheumatic fever, ankylosing spondylitis, and gout are less common and milder in older adults.
    • Chondrocalcinosis (pseudogout) and polymyalgia rheumatica are characteristic of higher age, while late-onset rheumatoid arthritis can be aggressive, presenting with high sedimentation rates, shoulder arthritis, and systemic symptoms, often mimicking malignancies or paraneoplastic arthritis.

    Impact:

    • Improved diagnostic accuracy for inflammatory rheumatic diseases in geriatric populations.
    • Enhanced understanding of the varied presentations and prognoses of rheumatic conditions in older adults.
    • Reduced misdiagnosis of senile rheumatoid arthritis by recognizing its unique features and potential for confusion with neoplastic processes.

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