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Arthritis
This discussion post will cover the differences in pathophysiology between osteoarthritis and rheumatoid arthritis. Osteoarthritis according to Huether and McCance (2017), is characterized by the loss and damage of articular cartilage and inflammation (Huether & McCance, 2017). Osteoarthritis causes bone changes and thickening of the joint capsules causing inflammation and pain in the knees, hips, hands and spine. Rheumatoid arthritis however, is defined as an autoimmune disease characterized by inflammation in the joints, that leads to premature death (Hammer & McPhee, 2014). Both diseases effect the bones and joints by a chronic inflammatory process that changes bone and synovial formation; both disease also effect mostly the same body parts such as the knees and hips, with rheumatoid arthritis effecting mostly the hands. They differ greatly however in that rheumatoid arthritis is considered an autoimmune disease, similar to lupus. Rheumatoid arthritis can have systemic involvement and eventually causes premature death by a constant tissue and joint inflammation leading to citrullination eventually changing the structure and function of the proteins in the bones.
Factors
The two factors that impact the pathophysiology of these diseases is age and behavior. Huether and McCance (2017), state that osteoarthritis is most common in women over the age of 40. This impacts the pathophysiology of osteoarthritis because as women age the loss of articular cartilage becomes greater and intensifies the disease further. Behavior also plays a part in the pathophysiology of osteoarthritis as clinical presentations such as obesity puts excessive stress on the joints furthering the chondrocyte death in joints such as the knees. Changing lifestyle habits such as obesity can take stress of these joints and lower the patient risk of furthering arthritis. Rheumatoid arthritis on the other hand, according to John Hopkins Arthritis Center (2017), increases with age, approaching 5% in women over age 55. This factor effects the pathophysiology as people age so does the inflammatory process. The citrullination process in rheumatoid arthritis speeds up with age causing a further breakdown of proteins like fibrin and vimentin. The behavioral aspect of rheumatoid arthritis is not as prevalent as it is an autoimmune disease and the true cause is unknown. However, smoking and diet are behavioral factors shown to worsen the diagnosis and prognoses of rheumatoid arthritis (Huether & McCance, 2017).
Diagnosis and Treatment
Diagnosis and treatment of each disorder is different. Osteoarthritis diagnosing consists of clinical signs and symptoms and diagnostic testing to physically see the damage of the bones and joints. Treatment consists of some behavioral changes such as weight loss and NSAID use to eliminate some inflammation. Physical therapy can also be helpful to regain use and strength of the bone structures (Huether & McCance, 2017). The diagnosing of rheumatoid arthritis is more complicated as it is an autoimmune disease. Most importantly the clinical manifestations and detailed patient interviews are the most helpful in diagnosing rheumatoid disorders; such as joint swelling and pain in the hands. Other diagnosing includes bloodwork showing the rheumatoid factor which is an autoantibody present in the blood when rheumatoid arthritis is present. Other blood results such as C reactive protein show chronic inflammation present in most autoimmune diseases. Treatment for rheumatoid arthritis is mostly pharmacological with medications such as disease-modifying antirheumatic drugs (DMARDs) and methotrexate, which remains the first line of treatment for rheumatoid arthritis (Huether & McCance, 2017).
References
Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
John Hopkins Arthritis Center. (2017). Retrieved from https://www.hopkinsarthritis.org/arthritis- info/rheumatoid-arthritis/ra-symptoms/