Dimant J
J Am Geriatr Soc. 1979 Apr;27(4):183-5. doi: 10.1111/j.1532-5415.1979.tb06444.x.
Two elderly patients presented with generalized aches and pains (particularly in the shoulders and the pelvic girdle), stiffness, fatigue, anemia, and an elevated erythrocyte sedimentation rate, but there were no signs or symptoms directly referable to the joints. Two and five months later respectively, pain, swelling, and signs of synovitis appeared in several joints in a symmetrical pattern, and a diagnosis of rheumatoid arthritis was made. Rheumatoid arthritis in the elderly may resemble polymyalgia rheumatica. On the other hand, synovitis in many patients with polymyalgia rheumatica may resemble rheumatoid arthritis. In the elderly, the differentiation of these two entities may be difficult. Moreover, patients initially presenting with the signs and symptoms of polymyalgia may eventually manifest typical rheumatoid arthritis.
两名老年患者出现全身疼痛（尤其是肩部和骨盆带）、僵硬、疲劳、贫血以及红细胞沉降率升高，但无直接与关节相关的体征或症状。分别在两个月和五个月后，多个关节出现疼痛、肿胀和滑膜炎体征，呈对称分布，诊断为类风湿关节炎。老年人的类风湿关节炎可能类似风湿性多肌痛。另一方面，许多风湿性多肌痛患者的滑膜炎可能类似类风湿关节炎。在老年人中，区分这两种疾病可能很困难。此外，最初表现为风湿性多肌痛体征和症状的患者最终可能会出现典型的类风湿关节炎。
