Inflammatory arthropathy: A review of rheumatoid arthritis in older patients

Rheumatoid arthritis (RA) is the most common inflammatory synovitis in older adults. The primary care physician may see its presentation as the late stage of a long-term disorder, or alternatively as an elderly-onset disease. These two presentations of RA may differ significantly with respect to mode of onset, prevalence of associated systemic symptoms (eg, fatigue, weight loss, depression), criteria for diagnosis (eg, rheumatoid factor or rheumatoid nodules), progression of disease, and functional outcomes. Because RA is responsive to treatment, and new treatments are available, diagnosis of this disorder is imperative. Differential diagnostic possibilities and therapies are reviewed, with particular emphasis on the cause and effect of comorbid diseases such as infection, osteoporosis, and cardiovascular disease.