Osteoarthritis vs Rheumatoid Arthritis

Introduction

Definition: Progressive degeneration of articular cartilage in a joint
Cause: Excessive mechanical stress on weight-bearing joints leading to wear and tear
Pathophysiology: Release of enzymes → inflammation → bone spurs → decreased mobility
Risk Factors:
- Older age
- Female gender
- Smoking
- Obesity
- Repetitive stress on the joints
Signs & Symptoms:
- Joint pain and stiffness
- Enlarged joints
- Crepitus (crunching sound)
- Heberden's nodes (distal interphalangeal joints)
- Bouchard's nodes (proximal interphalangeal joints)
Medications:
- Oral analgesics (e.g., NSAIDs)
- Topical medications (e.g., Voltaren gel, capsaicin)
- Supplements (e.g., glucosamine)
- Injections (corticosteroids, hyaluronic acid)
Patient Teaching:
- Balance rest with activity
- Weight loss if applicable
- Strength training and physical therapy
- Yoga and tai chi for exercise
- Ice for acute exacerbations; heat for stiffness
- Use of splinting and assistive devices

Definition: Autoimmune disorder causing inflammation and destruction of articular cartilage and bone
Characteristics: Periods of exacerbation and remission
Risk Factors:
- Female gender
- Ages 20-50
- Family history
Signs & Symptoms:
- Bilateral and symmetrical joint pain and swelling
- Morning stiffness
- Ankylosis (joint fixation and deformity)
- Swan neck deformity
- Boutonniere deformity
- Ulnar drift
- Subcutaneous nodules
- Fever, red sclera, lymphadenopathy
Abnormal Labs:
- Positive rheumatoid factor
- Positive ANA (anti-nuclear antibody) titer
- Elevated WBC, CRP, ESR
Imaging Tests:
- X-ray
- MRI
- Arthrocentesis (checking synovial fluid)
Treatments:
- Immunosuppressants (e.g., prednisone, methotrexate)
- NSAIDs for pain control
- Hydroxychloroquine
- Plasmapheresis
- Physical and occupational therapy
Nursing Care:
- Monitor for complications (e.g., Sjogren's syndrome)
- Patient teaching: Warm showers for morning stiffness, engage in physical activity, use assistive devices

Type of Disease:
- Osteoarthritis: Degenerative
- Rheumatoid Arthritis: Inflammatory (autoimmune)
Pain Characteristics:
- Osteoarthritis: Pain with activity, relieved by rest (end-of-day pain)
- Rheumatoid Arthritis: Morning stiffness, pain relieved by activity
Joint Involvement:
- Osteoarthritis: Specific joints, often unilateral
- Rheumatoid Arthritis: All joints, bilateral and symmetrical
Deformities/Nodes:
- Osteoarthritis: Heberden's and Bouchard's nodes
- Rheumatoid Arthritis: Swan neck and boutonniere deformities, ulnar drift
Lab Results:
- Osteoarthritis: Negative rheumatoid factor
- Rheumatoid Arthritis: Positive rheumatoid factor