Difference Between Osteoarthritis and Rheumatoid Arthritis

Main Difference –  Osteoarthritis vs Rheumatoid Arthritis

Arthritis is a general term used to describe inflammation of the joints.Osteoarthritis and Rheumatoid Arthritis (RA) are two disease types which are known to affect the musculoskeletal system in several ways. Their prevalence in the modern society is quite high, but with timely interventions, the negative impact on the quality of life can be eliminated. The main difference between osteoarthritis and rheumatoid arthritis is that osteoarthritis is a degenerative, wear and tear type disorder whereas rheumatoid arthritis is an autoimmune condition.

This article explains,

1. What is Osteoarthritis
– Definition, Cause, Risk Factors, Signs and Symptoms, Diagnosis, Treatment

2. What is Rheumatoid Arthritis
– Definition, Cause, Risk Factors, Signs and Symptoms, Diagnosis, Treatment

3. What is the difference between Osteoarthritis and Rheumatoid Arthritis

What is Osteoarthritis

Also known as Arthrosis, osteoarthritis is a degenerative type of disorder which is known to be the commonest form of arthritis seen in the community.

It occurs as a result of wearing off of the protective cartilage at the end of joints over time. This cartilage acts a friction absorbing cushion, and the absence of it can lead to a continuous friction generated on rubbing the bones with one another, ultimately ending up with a worn-off joint. Even though this condition can damage any joint in the body, most commonly affected joints include hands, knees, hips, and spine.

Advanced age, obesity, trauma to the joints, genetics, bone deformities (malformed/defective cartilage), long-term weight bearing and heavy weight lifting can be risk factors for osteoarthritis; females are at a higher risk than males. More often, this affects people over 40 years of age but it can also be seen in youngsters following accidents and trauma.

Patients with osteoarthritis usually experience pain around the affected joints, difficulty in moving them due to stiffness; pain and stiffness are aggravated more towards the morning just after waking up which usually lasts for more than 30 minutes. In addition, these people will also complain of loss of flexibility, limited range of movements, loss of muscle bulk, a grating sensation on moving joints and spurs which present as hard bony-like structures over the skin around the affected joints.

Osteoarthritis should be diagnosed as early as possible and timely interventions should be made since it can lead to a lifelong debilitating condition where the patients will no longer be able to work.

Your physician will take a complete history and do a thorough physical examination, looking for signs of inflammation such as pain, tenderness, swelling, redness and difficulty in moving and come to a general diagnosis. However, this will further be confirmed by an X-ray (worn off bones, absent cartilages and spurs could be seen) with or without MRI. Furthermore, blood tests (ESR) and joint fluid analysis can also be important in order to exclude other mimicking conditions such as rheumatoid arthritis and gout.

Even though there is no complete cure for osteoarthritis, lifestyle modifications, and pharmacological interventions are known to help with the symptoms.

• Lifestyle modifications – Regular exercises, maintaining a healthy Body Mass Index, avoid stress on joints by heavy weight lifting
• Medications
  – Pain relief-: Acetaminophen can be used for mild-moderate pain, but long term usage can lead to liver damage.
  – Non-steroidal anti-inflammatory drugs (NSAIDs) – Ibuprofen, Naproxen sodium
  – Anti-depressants such as Duloxetine – to treat chronic pain

• Physiotherapy
• Occupational therapy
• Surgical interventions – Corticosteroid injection to relieve severe pain and inflammation

– Hyaluronic lubrication injections
– Re-aligning bones
– Joint replacement surgery or Arthroplasty- Removal of damaged joint surfaces and replacing them with metal or plastic parts.

What is Rheumatoid Arthritis

Rheumatoid arthritis is a chronic autoimmune condition which is characterized by pain, tenderness, swelling and stiffness in the affected joints including hands, feet, and wrists, in a symmetrical manner. This can also result in extra-articular manifestations involving skin, eyes, lungs, blood and nerves.

Even though the exact etiology of rheumatoid arthritis is not clear, it is an autoimmune condition where the body produces antibodies against its own cells. Some scientists suggest that microorganisms such as virus and bacteria play a major role in pathophysiology where smoking is thought to be another.

Accounting for a significant female predominance, Rheumatoid Arthritis usually affects young people around the age of 20. The majority of the patients with Rheumatoid Arthritis experience an acute onset of joint pain, tenderness, swelling and limping in joints all over the body which will gradually progress over weeks. Other extra-articular symptoms can include fever, loss of appetite and weight, generalized body aches, red eyes, rheumatoid nodules over the skin, anemia, etc. Patients can also experience aggravated joint pains in the morning which usually improves within 30 minutes in contrast to osteoarthritis pain.

Physicians are able to diagnose this condition by analyzing the signs and symptoms derived from a complete history along with information about the family background. This can be further confirmed using imaging studies such as X-RAY and MRI along with blood tests such as Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and cyclic citrulline antibody test (anti-CCP).

The treatment plan for Rheumatoid arthritis mainly includes lifestyle modifications and pharmacological interventions.

• Lifestyle modifications – Regular exercises when the inflammation is controlled and appropriate rest during severe flare-ups.
• Medications
  – Anti-inflammatory agents
  – Pain relievers (Narcotics)
  – Corticosteroids
  – Disease-modifying anti-rheumatic drugs (DMARDs) – Hydroxychloroquine, Immunosuppressants such as methotrexate

Even though there is no lifelong cure for Rheumatoid Arthritis, timely interventions can definitely prevent disability.

Difference Between Osteoarthritis and Rheumatoid Arthritis

Type of Diseases 

The major difference between Osteoarthritis and Rheumatoid Arthritis lies in the nature of the natural course. Even though both these conditions affect our musculoskeletal system, Osteoarthritis is a degenerative, wear and tear type disorder whereas rheumatoid arthritis is an autoimmune condition.

Age Groups

Both these conditions have a significant female predominance, but osteoarthritis usually affects people over 40 years of age whereas the incidence of rheumatoid arthritis is higher among young individuals around the age of 20.

Cause

Osteoarthritis is a result of long-term pressure on large joints such as hips, knee, elbow, resulting in a wearing off whereas the exact etiology of rheumatoid arthritis is not very clear, suggesting the influence of a genetic predisposition and long-term smoking.

Signs and symptoms

Osteoarthritis:

• Joint pain, tenderness and stiffness around hands, fingers, and knees
• One side is badly affected than the other
• Morning stiffness for more than 30 minutes

Rheumatoid arthritis:

• Multiple joint pain, stiffness, and tenderness
• Symmetrical symptoms
• Morning stiffness which improves within 30 minutes of activity
• Extra-articular manifestations such as fatigue, fever, loss of weight and malaise

Diagnosis

These two conditions can easily be diagnosed with a clear history but XRAY, MRI and blood tests can be used to confirm the diagnosis. Wearing off of joints, absent cartilages and spurs can be seen in an X-ray of a patient with osteoarthritis. ESR, CPR, anti-CCP may be elevated in rheumatoid arthritis whereas there will be no change in Osteoarthritis.

Treatment

Pain relief, symptomatic management, and prevention from further destruction are the main targets of management. Rheumatoid arthritis specifically has to be treated with immune-suppressants. Both Osteoarthritis and RA have no long term cure, but with timely interventions, complications can be halted.

Image Courtesy:

“Osteoarthritis” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia

“Rheumatoid arthritis joint” By US gov (Public Domain) via Commons Wikimedia

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