Chronic polyarthritis in advanced age

Approximately a quarter of polyarthritis in the elderly is beginning with a single- or oligo-articular attack of big joints. The first attack of the shoulder joints is noticed especially in men. Most of the patients with rheumatoid arthritis in the elderly have a gradually progressive course. There is often showed a very high blood sedimentation rate (BSR); rheumatoid factor is rare. Generally there is a strongly marked osteoporosis. The success of therapy with disease modifying agents is comparable with that of younger patients with rheumatoid arthritis, but there is a smaller tolerance to gold and D-penicillamine. In some non-steroidal anti-rheumatic drugs a lower dosage is recommended.