Le Parc Jean-Marie
Service de rhumatologie, hôpital Ambroise Paré, Boulogne-Billancourt.
Rev Prat. 2005 Dec 15;55(19):2115-20.
Inflammatory arthritis of the elderly have growned new interest because of their frequency and also because new syndromes or subsets of arthritis of the young adults have been recently described. The originality of seropositive rheumatoid arthritis beginning after 70 years old is that management and prognosis are not different from early onset a RA. Various subsets of mild seronegative arthritis of the elderly that pose diagnostic problems with polymyalgia rheumatism (PMR) are also described. New syndromes, at least partly, presents as an original expression of late onset arthritis. Theses syndromes are characterized by rapid onset of arthritis with pitting non inflammatory oedema (RS3PE, described by McCarthy). Same syndromes resistant to steroids will reveal hemopathy or metastastic carcinoma. Late onset of inflammatory spondylarthropathy presenting as undifferentiated arthritis, fever, loss of weight and large oedemia is probably the most original presentation of arthritis specific to old males.
老年炎症性关节炎因其发病率以及近期新描述的年轻成人关节炎新综合征或亚组而受到了新的关注。70岁以后起病的血清阳性类风湿关节炎的独特之处在于其治疗和预后与早发型类风湿关节炎并无不同。还描述了老年轻度血清阴性关节炎的各种亚组，这些亚组在诊断上与风湿性多肌痛（PMR）存在问题。新综合征至少部分表现为迟发性关节炎的一种独特表现形式。这些综合征的特征是关节炎起病迅速，并伴有凹陷性非炎性水肿（RS3PE，由麦卡锡描述）。对类固醇耐药的相同综合征可能会揭示血液病或转移性癌。表现为未分化关节炎、发热、体重减轻和大量水肿的迟发性炎性脊柱关节病可能是老年男性特有的关节炎最独特的表现形式。
