{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:12:00Z","timestamp":1791479520415,"version":"4.3.4"},"reference-count":56,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med&amp;#65533;Insights&amp;#65533;Arthritis&amp;#65533;Musculoskelet Disord"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Medical history, Health Assessment Questionnaire Disability Index (HAQ-DI), DAS 28 score, laboratory investigations, and MSUS of both hands and wrist joints were done.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      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%) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0143). A significant difference was also observed between the 2 groups regarding higher ESR values in LORA, with no significant difference detected in C-reactive protein (CRP) levels. Regarding joint involvement, shoulder, metatarsophalangeal (MTP), and knee joints were more frequently affected in LORA, with statistically significant differences (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001, .0119, and .0285, respectively). The MSUS findings revealed higher gray-scale grades in patients with LORA, with significantly increased Doppler signal activity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.052), and a greater frequency of erosions compared with those with EORA. The mean HAQ-DI score was significantly higher in LORA than in EORA (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.0004). Regarding treatment patterns, methotrexate (MTX) was more commonly prescribed in the EORA group (67.1%) compared with the LORA group (37.5%), whereas leflunomide was used more in LORA (68.75%) compared with EORA (46.8%), with statistically significant difference.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11795441261429109","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T22:48:47Z","timestamp":1774306127000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Sonographic Pattern of Late-Onset and Early-Onset Rheumatoid Arthritis: Comparative Study"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-7558","authenticated-orcid":false,"given":"Nermeen Noshy","family":"Aziz","sequence":"first","affiliation":[{"name":"Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1705-9477","authenticated-orcid":false,"given":"Rasha Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3741-9940","authenticated-orcid":false,"given":"Rehab Ali","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Rehabilitation and Physical Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-0713","authenticated-orcid":false,"given":"Naglaa","family":"Afifi","sequence":"additional","affiliation":[{"name":"Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-3750","authenticated-orcid":false,"given":"Rasha N","family":"Thabet","sequence":"additional","affiliation":[{"name":"Department of Internal medicine and Rheumatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ken205"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-020-0413-5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12070-021-02747-x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.3.228"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-004-1067-4"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.051144"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-022-02952-1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rdc.2006.12.006"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215920"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X17740075"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3109\/rhe1.1957.3.issue-1-4.28"},{"key":"e_1_3_3_13_2","first-page":"607","article-title":"Rheumatoid arthritis in old age","volume":"2","author":"Adler E.","year":"1966","unstructured":"Adler E. 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