You knew this topic was coming. So what is the difference?
Osteoarthritis (what we generally think of when speaking of arthritis) is also dubbed the wear-and-tear arthritis, named such because it involves the wearing down of joint cartilage due to aging and overuse. The cartilage serves as a shock-absorber and cushion between two bones of a joint, and as it breaks down the bones may come into direct contact with each other resulting in severe pain. It is the most common form of arthritis, with 21 million Americans afflicted with the disease. Interestingly, although osteoarthritis is not an inflammatory disease, as the “-itis” ending may lead us to believe, the immune system does have a role with cytokines IL-1 and TNF-α, in addition to NO and prostaglandin E2, posing as the suspects. Surely, there is also local inflammation at the site of the disease as well. This condition is commonly brought about by injury (such as a sports injury), but can also be instigated by weak muscles, obesity, or plain heredity. There is no known cure for this disease, and it is currently the leading cause of chronic disability in the United States. This is scary considering I had previously sustained two tears in my lateral meniscus of my left knee, and underwent surgery just this summer to fix it. The orthopedic surgeon excised 40% of my meniscus (a substantial amount), and he seemed to be of the notion that I would not be at additional risk of acquiring arthritis because of it. All I can say is that I hope he's right!
Now, rheumatoid arthritis is clearly a chronic, inflammatory disease, where the body's immune cells attack the host's own healthy tissues (the characteristics of an autoimmune disease). In response to this, the white blood cells rush to the synovium and start the inflammatory process. Thus, the distinguishing characteristic between rheumatoid arthritis and other forms of arthritis is that the inflammation takes place at the synovial membrane, where swelling usually is caused by the buildup of synovial fluid (in the knees or fingers, e.g.). Rheumatoid arthritis tends to affect the smaller joints first, and can spread throughout the body. A tell-tale sign of this disease is morning stiffness of the joint for 30 min to one hour (following sleep), followed by a gradual alleviation with activity. The causes are not clearly known, and there is also no cure for this one yet.
Subscribe to:
Post Comments (Atom)
How do the drug/physical therapies differ between these two?
ReplyDeleteAre there certain autoantibodies that are associated with these two diseases that can serve as a predictor? If so, are they different for each disease?
ReplyDeleteAnother interesting point about rheumatoid arthritis is that it is a systemic autoimmune disease that affects more than just the articular joints. Lung disease and cardiovascular problems (amongst others) can result from rheumatoid arthritis.
ReplyDeleteInteresting topic as rheumatoid arthritis is a nasty disorder! (as is Osteoarthritis). From my understanding, RA being systemic affects many tissues and organs whereas OA is a non-inflammatory problem of degradation of joints and loss of cartilage. Which would be easier to treat? and what causes the onset of the rheumatoid factor accumulation in most RA patients?
ReplyDeleteFor osteoarthritis, the drugs typically given generally serve the purpose of pain relief and maintenance of joint movement. They include such drugs as acetaminophen (e.g. Tylenol), Tramadol, and even stronger painkillers. As for rheumatoid arthritis, the goal is to reduce inflammation in the joints in order to relieve pain and prevent or slow joint damage. The standard treatment of rheumatoid arthritis includes prescription of disease-modifying anti-rheumatic drugs (DMARDs) which slow the disease progression and save the affected tissue from permanent damage. Furthermore, (cortico-)steroids, immunosuppressants, TNF-alpha inhibitors, and other anti-inflammatory drugs may be administered. The difference in drug therapies between the two diseases reflect their differences in nature, i.e. with rheumatoid arthritis being an inflammatory disease.
ReplyDeleteAs far as the physical therapies, I did not find much difference, except the differences which come with dealing with smaller joints (as is most commonly the case with rheumatoid arthritis) compared to bigger joints.
The autoantibody IgG (Rheumatoid factor) is associated with rheumatic arthritis. Osteoarthritis is not an autoimmune disease, however, and therefore no autoantibodies are involved.
Although both types of arthritis are currently incurable, rheumatoid arthritis is more difficult to treat for exactly the reasons you've stated Lysa. The fact that it is an inflammatory disease that is capable of migrating to other parts of the body adds an entire dimension to the problem, and additional obstacles in treating it.
ReplyDeleteIt has been shown that the amount of rheumatoid factor in the body is correlated with the progression of the inflammatory response. Regarding what triggers this accumulation in the first place, the reason for that is still not understood.