Osteoarthritis vs Rheumatoid Arthritis

Osteoarthritis (OA) and Rheumatoid Arthritis (RA) both are inflammations of joints. OA is a condition that tends to occur as we get older and doesn’t affect the joints Symmetrically (same joint on each side of the body). OA typically affects the bigger joints of the human body such as the Knee and Hip. On the other hand, Rheumatoid Arthritis is another inflammatory type of arthritis and it affects in the early stages the small joints of hands and feet. A person might have RA if he/she get pain and swelling in the joint area specifically and critically. There’ll be some Stiffness in the joints and mostly the stiffness is worst in the morning rather than at night.

Osteoarthritis:-

OA is an age-related joint inflammation that involves inflammation of only joints. Basically, it is due to the constant wear & tear. This causes the destruction of the cartilage. That’s why we also called it Destructive joint disease.

Predisposing Factors of OA:-

1). Age – typically in old age.

2). Obesity.

3). Joint Trauma – Overuse of the destruction of the joint cause of the cartilage. This leads to the polishing of the bone surface which causes extreme pain in the joint.

Features of Osteoarthritis:-

There is minimal inflammation of the joint cause narrowing of the joint space with no Ankylosis (joining of bones). Pain occurs when there is an overuse of the joint. The deformity is very rare and joint pain only during weight-bearing. No redness, warmth and swelling.

Process of Osteoarthritis:-

Overuse of the joint, the cartilage gets destructive. After the destruction, the body’s natural healing process started over there and heal the cartilage tear and loss. New cartilage is generated because of chronic conditions. The new cartilage didn’t make the property and that cartilage starts ossification and form bony Spurs which we called osteophytes. These osteophytes decrease the joint space and also give a cracking sound in the joint during the movement and cause pain. Typically, these osteophytes also resist joint movement.

Investigation of Osteoarthritis:-

The patient will complain of pain in the weight-bearing joints (hip, knee and vertebrae joints).

Also, important involvement in the DIP joint (Heberden Nodes) and PIP joints (Bouchard Nodes). No involvement of MCP joint.

On X-ray, we find joint space narrowing osteophytes. The articular cartilage would be ulcerated and thinned. There would be a Selerotic zone on the bone and slight synovial hypertrophy.

Treatment of Osteoarthritis:-

1). Medication.
2). Physiotherapy.
3). Joint Replacement.

 

Rheumatoid Arthritis:-

RA is a chronic inflammation Autoimmune disease. This is an autoimmune hypersensitivity type 3 reaction which means antigen-antibody complex deposition on synovial sheath causing an inflammatory response which is joint destruction. There is an involvement of small joints of hands and feet.

Predisposing Factors of RA:-

1). Female.
2). HLA-DR4
3). Smoking.
4). Silica Exposure.
5). Positive Rheumatoid Factor.

Features of Rheumatoid Arthritis:-

RA is a systematic disease because disease arise from one joint and involved all the system of the body (Skin, Blood vessels, etc). It is an autoimmune disease. There is always a morning stiffness with joint pain. Multiple joints involved in RA. Deformities are also present. Resting pain is present. There is redness, warmth and the swelling present in the inflammatory joint.

Process of Rheumatoid Arthritis:-

Rheum means to flow and arthritis means inflammation of joints. RA is a type of disease that flows from one area to another. The synovial membrane of the joint is attacked by the immune system of the body and starts the inflammatory process. IgM & IgG bind with IgA and make an immune complex called the Rh factor.

Investigation of Rheumatoid Arthritis:-

Pain – mostly pain in the morning together with stiffness. The stiffness lasting up to more than 1 hour.

Ankylosis

Erosion

Joint space narrowing

Soft tissue swelling

Deformities and Subluxation

Fingers contain ulnar deviation with swan neck

Involves MCP, PIP and wrist joint. But not DIP and the first CMC joint.

Treatment of Rheumatoid Arthritis:-

1). Medication.
2). Physiotherapy.
3). Psychotherapy (Due to deformities in the body, the patient got depressed. To overcome this, we provide psychotherapy).