J Korean Rheum Assoc.  2007 Mar;14(1):85-90. 10.4078/jkra.2007.14.1.85.

A Case of Late onset Peripheral Spondyloarthropathy

• Chung JW
• Park TJ
• Choi GS
• Park HJ
• Kim HA
• Park HS
• Suh CH

• KMID: 2202195
• DOI: http://doi.org/10.4078/jkra.2007.14.1.85

Abstract

The spondyloarthropathies are a group of inflammatory rheumatic diseases including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease, and undifferentiated spondyloarthropathy. It usually begins in young or middle aged adults, but sometimes presents with atypical symptoms in the older patients. Late onset spondyloarthropathies are characterized by severe disease, marked elevation of laboratory parameters of inflammation, oligoarthritis involving the lower limbs with edema of the extremities. We described a 66-year-old patient who presented with asymmetric polyarthritis mainly involving lower extremities with fever, marked elevation of laboratory inflammatory markers, and was successfully treated with mini-pulse corticosteroids with disease modifying antirheumatic drugs.

Keyword

Spondyloarthropathy; Older patients; Inflammation; Corticosteroids

MeSH Terms

Adrenal Cortex Hormones
Adult
Aged
Antirheumatic Agents
Arthritis
Arthritis, Psoriatic
Arthritis, Reactive
Edema
Extremities
Fever
Humans
Inflammation
Inflammatory Bowel Diseases
Lower Extremity
Middle Aged
Rheumatic Diseases
Spondylarthropathies*
Spondylitis, Ankylosing
Adrenal Cortex Hormones
Antirheumatic Agents

Figure

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  Fig. 1. At the presentation, left 1st— 3rd MTP joints were swollen with local heating sensation.

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  Fig. 2. Pelvis X-ray images revealed subtle small erosion and sclerosis at both sacroiliac joint with poststatus of total hip replacement surgery at both hip joints.

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  Fig. 3. Bone scan image revealed hot uptake of radioisotopes at both knee, right ankle, left tarsometatarsal joint, left 1st ~ 3rd MTP joints of foot and T-L spines and mild uptake at right carpo-metacarpal joint.

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  Fig. 4. Changes of inflammatory laboratory markers during the course of treatment.

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