Rheumatoid Arthritis vs. Osteoarthritis

Rheumatoid Arthritis vs. Osteoarthritis

Overview

• Two common joint disorders that are often confused.
• Rheumatoid Arthritis (RA): Autoimmune condition.
• Osteoarthritis (OA): Irritated joint disease (degenerative).
• Differ in pathophysiology, symptoms, and treatment approaches.

Rheumatoid Arthritis (RA)

• Pathophysiology:
  • Autoimmune disorder attacking the synovial membrane (lining of the joint).
  • Leads to chronic inflammation.
  • Chronic inflammation results in scarring and joint deformity.
  • Antigen-antibody complexes deposit and attack the synovial membrane, causing chronic inflammation and joint disruption.
• Symptoms:
  • Primarily affects small joints (hands, wrists, feet).
  • Symmetrical involvement (affects the same joints on both sides of the body).
  • Morning stiffness lasting over an hour.
  • Joint swelling.
  • Systemic symptoms: fatigue, fever, periods of attacks and remissions.

Osteoarthritis (OA)

• Pathophysiology:
  • Degenerative joint disease caused by wear and tear.
  • Cartilage breaks down.
  • Synovial membrane is not primarily involved.
• Symptoms:
  • Affects weight-bearing joints (knees, hips, spine).
  • Pain and stiffness worsen with activity and improve with rest.
  • Morning stiffness is short-lived (less than 30 minutes).

Key Differences

• RA:
  • Autoimmune.
  • Small joints, symmetrical.
  • Morning stiffness > 1 hour.
  • Systemic symptoms.
• OA:
  • Degenerative (wear and tear).
  • Weight-bearing joints.
  • Morning stiffness < 30 minutes.
  • Pain worsens with activity.

Treatment

• RA:
  • Early intervention with Disease-Modifying Anti-Rheumatic Drugs (DMARDs).
  • Examples: methotrexate, biologic agents.
  • Requires immunosuppressants due to autoimmune nature.
• OA:
  • Managed primarily with pain control.
  • Analgesics (e.g., acetaminophen).
  • NSAIDs (Non-Steroidal Anti-Inflammatory Drugs).
  • Physical therapy.
  • Surgical treatments (joint replacement) for severe cartilage damage.
  • Lifestyle modifications and pain control focus.

NCLEX Key Points

• Joints involved (small vs. weight-bearing).
• Treatment approaches.
• Nursing education related to each condition.