OA & RA

What is osteoarthritis?

Degenerative joint disease involving cartilage loss and structural joint changes.

Typical OA pain pattern

Worse with use and improved with rest.

Typical OA stiffness pattern

Brief morning stiffness, usually under 30 minutes.

Common OA risk factors

Age, obesity, previous joint injury, repetitive use and genetics.

Common OA joints

Knees, hips, hands and spine.

Pathophysiology of OA

Cartilage breakdown, subchondral bone changes and low-grade inflammation.

OA symptoms

Pain, stiffness, reduced function, crepitus and reduced range of motion.

OA treatment goals

Reduce pain, improve function and maintain quality of life.

Non-drug OA management

Exercise, weight loss, education, physiotherapy and aids.

Why is exercise recommended in OA?

Improves strength, mobility and function.

Why is weight loss recommended in OA?

Reduces joint load and pain.

Why are topical options useful in OA?

Lower systemic adverse effect risk.

Nursing role in OA

Education, pain monitoring, function support and encouraging safe activity.

How does OA differ from RA?

OA is mainly degenerative, RA is autoimmune inflammatory.

OA prognosis

Chronic and progressive but symptoms can be managed.

What is rheumatoid arthritis?

Chronic systemic autoimmune inflammatory disease affecting synovial joints.

Main pathology in RA

Persistent synovitis causing joint damage.

Typical RA joint pattern

Symmetrical small-joint involvement.

Common RA joints

MCP, PIP, wrists, MTPs, knees and shoulders.

Typical RA stiffness pattern

Morning stiffness often longer than one hour.

Early RA symptoms

Fatigue, weakness, low-grade fever, joint pain and swelling.

Later RA complications

Joint deformity, tendon destruction, ankylosis and functional limitation.

Examples of RA deformities

Ulnar deviation, boutonnière deformity and swan-neck deformity.

Extra-articular RA features

Nodules, lung disease, eye/mouth dryness, neuropathy and cardiovascular risk.

RA risk factors

Genetics, smoking and environmental triggers.

Why is smoking important in RA?

Linked to development, severity and poorer response.

Why is early RA treatment important?

Prevents irreversible joint damage.

Why should suspected RA be referred urgently?

Early specialist treatment improves outcomes.

What is systemic inflammation?

Body-wide immune activation beyond local joints.

Inflammatory markers used in RA

ESR and CRP.

What are autoantibodies?

Antibodies directed against the body’s own tissues.

What is a DMARD?

Disease-modifying antirheumatic drug.

Purpose of DMARDs

Reduce inflammation and slow joint destruction.

What are biologic DMARDs?

Targeted therapies against immune mediators.

What are JAK inhibitors?

Targeted synthetic DMARDs affecting inflammatory signalling.

Key cytokines in RA

TNF-alpha, IL-1 and IL-6.

Nursing role in RA

Monitor symptoms, function, adherence, infection risk and medicine adverse effects.

How does RA affect quality of life?

Pain, fatigue and disability can affect work, family and social participation.

Difference between OA and RA pain timing

OA worsens with use, RA is often worse after rest/morning.

Difference between OA and RA pathology

OA cartilage degeneration, RA autoimmune synovitis.