Osteoarthritis and Rheumatoid Arthritis Essay

Similarities and Differences between the Pathophysiology of Osteoarthritis and Rheumatoid Arthritis

Both osteoarthritis and rheumatoid arthritis are the most common conditions of the musculoskeletal system which affect people across the United States. Approximately 13.9% of adults above or equal to 25 years of age are affected by osteoarthritis. This incidence increases with age and is more common among women after 50 years of age (Huether & McCance, 2017).

In comparison, rheumatoid arthritis is an autoimmune condition that is characterized by inflammation of bilateral joints with systemic symptoms of fever or fatigue.  An estimated 1.5 million adults are affected younger adults are particularly at risk with recurrence between 20-30 years of age. The incidence is also higher in women as compared to men with a lifetime risk of 3.6 % (Huether & McCance, 2017).Osteoarthritis and Rheumatoid Arthritis Essay

For the purpose of this assignment, the patient factors selected are age and genetics. In osteoarthritis, the process of aging impacts the components and matrix structure of extracellular cartilage. Advanced age is also associated with a reduction in chondrocyte function and the rate of responding to stimuli. The bone remodeling process as stimulated by the use or movement of the joint is changed by a series of cellular, mechanical and biochemical processes in advanced age leading to abnormal cartilage reparation and progressive degradation (Pap & Korb-Pap, 2015).  This results in continuous loss of cartilage, increasing the thickness of the subchondral plate, formation of subchondral bone cysts and osteophytes. With progression, the vascular system is invaded and surrounding articular cartilage calcifies hence reduces in thickness (Pap & Korb-Pap, 2015).

In rheumatoid arthritis, genetics and hormones may trigger an initial immune response making the immune system cells to produce inflammatory cytokines and autoantibodies resulting to an inflammation cascade and pannus formation (Okada, et al., 2014). The pannus then invades the bone and cartilage and destroys them. What follows is additional damage to the joint and systemic complications from the joint that is affected. Osteoarthritis and Rheumatoid Arthritis Essay

Diagnosis and Treatment

The diagnosis of osteoarthritis based on age as a patient factor is based on physical examination and history of the patient. In advanced age, radiology results show asymmetrical narrowing of joint space which indicates that cartilage has been lost (Glyn-Jones, et al., 2015).  Osteophytes may also be present an indication of bony overgrowth. Other signs include crepitus at the joints, joint tenderness, and limited mobility.

The diagnosis of rheumatoid arthritis based on genetics as a patient factor requires a comprehensive patient history, physical examination, radiologic and laboratory tests. A positive family history of rheumatoid arthritis especially from first degree relatives is a possible finding (Okada, et al., 2014). On physical exam, the affected joint will be warm, erythematous and tender with a swollen appearance as a result of increased blood flow and synovitis from the formation of a pannus. Morning stiffness of affected joints that lasts for more than 30 minutes, a positive rheumatoid factor and bony erosions on radiography are also common findings (Okada, et al., 2014).Osteoarthritis and Rheumatoid Arthritis Essay

Treatment aims at improving the mobility and functionality of patients. In osteoarthritis, treatment is largely symptomatic while in rheumatoid arthritis, treatment aims at slowing down or preventing the progression of the disease and joint destruction (Huether & McCance, 2017).

Treatment may be pharmacological or non-pharmacological. The latter includes non-weight bearing exercises to maintain the function of joints, weight loss to reduce stress on joints that bear weight. CBT has also proven to be highly effective in managing the symptoms of both conditions in improving individual and social care capabilities (Huether & McCance, 2017).

For pain and inflammation, painkillers and anti-inflammatory medications are prescribed respectively.Osteoarthritis and Rheumatoid Arthritis Essay