Clinical and Sonographic Pattern of Late-Onset and Early-Onset Rheumatoid Arthritis: Comparative Study.

Background: Late-onset rheumatoid arthritis (LORA) poses a great challenge for physicians regarding diagnosis and treatment. The prognosis for LORA was better in some early research but worse in more recent trials. Objectives: The study aim was to compare the clinical, laboratory, and radiological characteristics assessed by musculoskeletal ultrasound (MSUS) of patients with LORA and early-onset rheumatoid arthritis (EORA) and to examine their associations with inflammation and treatment outcomes. Design: The study included 64 RA with EORA and 64 RA patients with LORA, fulfilling the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 criteria for RA. Methods: Medical history, Health Assessment Questionnaire Disability Index (HAQ-DI), DAS 28 score, laboratory investigations, and MSUS of both hands and wrist joints were done. Results: Female patients with EORA were more compared with those with LORA (89% vs 78.1%). Comorbidities were significantly more prevalent in the LORA group (28.12%) compared with the EORA group (10.9%) ( Conclusions: Patients with LORA demonstrated more active synovitis and a higher frequency of erosions compared with those with EORA, despite the non-significant difference in DAS 28 scores. Moreover, patients with LORA exhibited a greater burden of comorbidities than those with EORA. Therefore, regular evaluation of inflammatory activity using MSUS, along with assessment of associated comorbid conditions, is recommended in patients with LORA.