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Management of common types of arthritis in older adults 

Management of common types of arthritis in older adults
Management of common types of arthritis in older adults
Oxford Textbook of Geriatric Medicine (3 edn)

James B. Galloway

and David L. Scott


The main forms of inflammatory arthritis are rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. They are long-term disorders and consequently their prevalence increases with age; the lifetime risk of developing rheumatoid arthritis is over 3% in women. Their characteristic features comprise joint pain, swelling, and tenderness, morning stiffness, and general symptoms such as malaise. Polyarthritis is commoner in rheumatoid arthritis. The ESR and C-reactive protein levels are high in active arthritis. The main radiological finding is erosive disease. Symptomatic treatment includes analgesics and non-steroidal anti-inflammatory drugs. Disease-modifying drugs (DMARDs) change the course of these diseases; their main use is in rheumatoid arthritis. Biologic drugs help when other treatments are insufficient; they include tumour necrosis factor inhibitors which benefit all types of inflammatory arthritis, and other biologics targeting B- and T-cells are mainly used in rheumatoid arthritis. The risks of adverse events and drug toxicity are higher in elderly patients.

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