Abstract
Rheumatoid arthritis (RA) has multiple manifestations. Patients present with a variety of symptoms and varying levels of severity. Elderly-onset rheumatoid arthritis (EORA) is described as RA with onset after 60 years of age. EORA can present with different clinical and laboratory findings compared to RA in a younger patient, making awareness of the condition important. Diagnosing inflammatory arthritis can be especially challenging in an elderly population where symptoms are poorly reported and communication is often difficult. We report the case of an elderly patient whose presentation with persistent tachycardia and raised inflammatory markers led to a diagnosis of EORA. This case details an atypical presentation of EORA with convincing diagnostic features for the disease without any joint symptoms reported. Clinicians should be aware of the differences in the typical presentation of EORA versus RA, the challenges of diagnosing inflammatory arthritis in elderly, isolated patients, and the importance of early diagnosis.