Rheumatoid Arthritis In The Elderly
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Contents |
Etiology
Epidemiology
- more* equal sex distribution
- 23-30% of patients present > 60 years of age
Pathology
- closely linked with polymyalgia rheumatica in the elderly
Clinical-manifestations
- higher* frequency of abrupt onset
- more* large joint complaints
- less* extra- articular disease
- longer* morning stiffness
- less often* have rheumatoid nodules
- fewer* symptoms
Laboratory
- higher* erythrocyte sedimentation rate (ESR)
- 50% rheumatoid factor ( RF) positive
Complications
Differential-diagnosis
- closely linked with polymyalgia rheumatica in the elderly
Management
- see rheumatoid arthritis
- pharmaceutical agents
- methotrexate is drug of choice in the elderly [2]
- prognosis
- heterogenous group with favorable functional prognosis
- subgroup of women with functional disability at onset has worse outcome
- positive rheumatoid factor & symmetrical polyarthritis has increased mortality compared to seronegative group
- * in comparison to younger patients
More General Terms
References
- Weiner S, In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
