Walter H. Ettinger Rheumatoid Arthritis A chronic syndrome of symmetric inflammation of the peripheral joints, resulting in progressive destruction of articular and periarticular structures. Prevalence of rheumatoid arthritis increases up to age 80. Rheumatoid arthritis is an important cause of disability in elderly persons. The cause is unknown. Intense inflammation of the synovium of the diarthrodial joints is characteristic.
Synovial tissue becomes hyperplastic and infiltrated with lymphocytes and plasma cells.
Various inflammatory mediators, including cytokines, prostaglandins, and immunoglobulins, are present in the synovial fluid. In many elderly patients, the disease process began during middle age. Some patients have secondary joint deformities and degenerative changes even though the inflammation is inactive. When rheumatoid arthritis develops de novo in an elderly person, the onset may be insidious or acute. Fever and night sweats occasionally are reported.