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[Polyarthritis in the elderly]

M Caroit1

  • 1Service de Rhumatologie honoraire de l'Hôpital Notre Dame de Bon Secours, Paris, France.

Zeitschrift Fur Gerontologie
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

Late-onset rheumatoid arthritis (RA) affects older adults and presents differently than adult-onset RA. Understanding these distinct patterns is crucial for accurate diagnosis and management in elderly patients.

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Area of Science:

  • Rheumatology
  • Geriatric Medicine
  • Internal Medicine

Context:

  • Rheumatoid arthritis (RA) can manifest in individuals over 60, representing 10-33% of all cases.
  • Late-onset RA (LORA) exhibits distinct clinical and demographic features compared to adult-onset RA.
  • Differentiating LORA from polymyalgia rheumatica (PMR) and other conditions like Remitting Seronegative Symmetrical Synovitis with Pitting Edema (RS3PE) is clinically significant.

Purpose:

  • To characterize the epidemiology, clinical presentation, and subtypes of late-onset rheumatoid arthritis.
  • To highlight the differences between LORA and typical adult-onset RA.
  • To emphasize the diagnostic challenges, particularly distinguishing LORA from polymyalgia rheumatica (PMR).

Summary:

  • Late-onset RA (10-33% of cases) is more common in males, has a rapid onset, frequently involves shoulders and hips initially, and shows higher erythrocyte sedimentation rates.

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  • LORA patients are less prone to rheumatoid nodules, extraarticular disease, positive serology, or poor outcomes.
  • Three patterns exist: classical, mild (often with Gougerot-Sjögren syndrome), and a shoulder/hip-predominant form resembling PMR, accounting for ~25% of LORA cases.

    • Impact:

    • Improved diagnostic accuracy for rheumatoid arthritis in the elderly population.
    • Enhanced understanding of the heterogeneity of late-onset rheumatoid arthritis.
    • Clinical guidance for differentiating LORA from polymyalgia rheumatica and RS3PE, optimizing patient care.