IS IT RHEUMATOID ARTHRITIS OR OSTEOARTHRITIS? WHAT'S THE DIFFERENCE?
MAY 16, 2019 @ 7.13 PM
Osteoarthritis and rheumatoid arthritis are two most common forms of arthritis that
occur as people age. It can cause similar aches and pains, but there are a few key differences between them.
Rheumatoid arthritis is an inflammatory condition in which your immune system attacks the tissues in your joints. It causes pain and stiffness that worsen over several weeks or a few months. Joint pain isn't always the first sign of rheumatoid arthritis—sometimes it begins with fatigue, fever, weakness and minor joint aches.
"Rheumatoid arthritis can appear in any joint. Its most common targets are the hands and wrists. In advance cases, it would be deformed," said Dr Mohamed Faizal Hj Sikkandar (pix), consultant orthopaedic surgeon and senior lecturer, Faculty of Medicine, University Teknologi Mara.
Osteoarthritis (OA) is a progressive joint disease due to failure in repair of joint damage. This may arise as a result of biomechanical, biochemical and/or genetic factors. The process may involve one or multiple joints.
As opposed to rheumatoid arthritis, osteoarthritis attacks larger joins - knee being the usual. So again, symptoms, include pain, swelling and in advanced stages – the knees become bent outwards.
“When an x-ray is conducted, we would see the joint space narrowed with spurs with some destruction of the joint for rheumatoid arthritis, while very marked changes in osteoarthritis. The hallmark difference in x-ray findings in both forms of arthritis would be the sub-joint involved.
Normal knee joints are made up of three components –the inner joint, the outer joint and the patellofemoral joint or the joint between the knee cap and the thigh bone.
“In osteoarthritis – typically the medial joins; the inner joins of the knee would be affected first, compared to rheumatoid arthritis where the outer joins; the lateral joins in addition to the patellofemoral joint," he added.
To simplify, rheumatoid arthritis and osteoarthritis present differently. Rheumatoid arthritis affect small joints first, then affects larger joints, while osteoarthritis affects large joints first with occasional presentation in small joints.
Gender also plays a role, said Faizal, highlighting that rheumatoid arthritis affects ladies more often than men, as it has a lot to do with hormones and genetics.
On the other hand, osteoarthritis, affects men as they are big built with larger joints.
“The other difference would be investigations. The blood specimen of a rheumatoid arthritis patient would contain factors such as a double stranded DNA, whereas in osteoarthritis, the diagnosis is rather straight forward – just by looking at large joint involvement - bad knees.
“Fingers comes in much later, but it is a rare manifestation for osteoarthritis, whereas for rheumatoid arthritis – it’s fingers first then the large joints.
Detecting arthritis before 60 years of age
Early symptoms for both forms of arthritis include on-off pain which comes even at rest, pain which comes with specific movements, postures, or specifically after trauma such as sports injury.
Other presentation include swelling which is usually on-and-off, crepeters which are sounds of the movement of joins and deformity which comes later on, which is an advanced form of the disease.
Exercise and participation in regular physical activity is generally recommended for adults with rheumatic diseases and musculoskeletal pain such as osteoarthritis.
Flexibility/range of motion exercises may be beneficial in improving symptoms associated with rheumatic diseases including pain, stiffness, and lack of mobility. Improved posture and greater comfort during movement also reduces the risk for sprains and strains and allows patients to safely undertake more strenuous forms of exercise like conditioning and aerobic exercise.
For a variety of reasons including inflammatory processes, medications and deconditioning, patients with arthritis suffer from decreased muscle function (strength, endurance, power) which in turn affects joint support and protection during load-bearing activities. Therefore, muscle-strengthening exercises are an important component of treatment for osteoarthritis and rheumatoid arthritis and are recommended two times per week for individuals.
Aerobic exercise may also yield a variety of health benefits including greater cardiovascular fitness, endurance and improved overall physical functioning.
Recent advances in osteoarthritis
Intra-articular Stem Cells
Stem cells have the capacity to produce all cell types in an unlimited fashion. Emerging evidence indicates that direct intra-articular injection of stem cells may boost the normally limited reparative process and limit the destructive process.
However, Malaysian Health Technology Assessment Section (MaHTAS) review showed that there was limited evidence on the benefits of stem cells in articular cartilage repair.
Autologous Chondrocyte Implantation (ACI)
Autologous chondrocyte implantation is an approach that has been used to treat symptomatic knee cartilage defects. The aim of this treatment is to replenish cartilage through the recruitment of progenitor cells as potential cartilage precursors, allowing the development into chondrogenic cells and finally, cartilage.
Platelet Rich Plasma (PRP)
Platelet rich plasma (PRP) is a natural concentrate of autologous blood growth factors studied in different fields of medicine in order to test its potential to enhance tissue regeneration.
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