Knee Arthritis Without Other Joint Symptoms in the Elderly With Seronegative Elderly Onset Rheumatoid Arthritis

Takatomo Mine*, Koichiro Ihara, Hiroyuki Kawamura, Ryutaro Kuriyama, Ryo Date
Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, Simonoseki, Japan

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© Mine et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, National Hospital Organization Kanmon Medical Center, 1-1Choufusotoura, Simonoseki, Yamaguchi 752-8510 Japan; Tel: +81-83-241-1199; Fax: +81-83-241-1301; E-mail:


Elderly onset Rheumatoid arthritis (EORA) has important clinical distinctions when compared with younger onset RA (YORA). In knee arthritis of elderly patients, infection, crystal-induced arthritis or EORA should be suspected if elevation of CRP in the preoperative examination and turbid joint effusion in their knee joint are found. Furthermore, if joint swelling and effusion remain after performing total knee arthroplasty (TKA), the infection after TKA, implant debris-related arthritis and EORA should be considered. However, it is difficult to diagnose patients as EORA if Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are negative. The differential diagnosis is very important.

Keywords: Arthroscopy, Synovitis, Knee arthritis, Rheumatoid arthritis, Elderly person, Seronegative RA.