Osteoarthritis and Rheumatoid Arthritis

Arthritis is considered as one of the major health conditions affecting a significant portion of the United States population. Even though the condition currently affects approximately 50 million adults in the country, it is not primarily an adulthood health condition. There are numerous cases of children suffering from arthritis, which implies that this condition is not uncommon among children. As a result of the prevalence of arthritis among children and adults, understanding the pathophysiology and symptoms of this condition has emerged as an important component in proper diagnosis and treatment. This paper examines the pathophysiology of osteoarthritis and rheumatoid arthritis in relation to the similarities and differences between the two conditions. The analysis includes a selection of two patient factors that could impact the pathophysiology, diagnosis and treatment of these conditions.
Pathophysiology of Osteoarthritis and Rheumatoid Arthritis
Arthritis is an umbrella term that refers to different conditions involving inflammation of the joints such as osteoarthritis and rheumatoid arthritis. Dewing et al. (2012) states that osteoarthritis and rheumatoid arthritis are among the most common musculoskeletal conditions that affect individuals in the United States, particularly adults. While osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis, these conditions differ in terms of pathophysiology, diagnosis and treatment. The underlying pathophysiology of osteoarthritis and rheumatoid arthritis differs though their basic manifestations involve the joints.
Osteoarthritis is considered as one of the most common forms of arthritis since it is an inflammation condition of the whole synovial joint and has numerous phenotypes (Mobasheri & Batt, 2016). This condition is distinguished by bony overgrowth and cartilage degeneration. In normal situations, cartilage experiences a remodeling process that is brought the movement or use of joints. However, under osteoarthritis, the remodeling process of cartilage is distorted through an amalgamation of cellular, mechanical, and biochemical processes. These processes contribute to increased cartilage degeneration and irregular reparation of cartilage. Progressive cartilage loss is the primary characteristic of osteoarthritis and is usually accompanied by development of new bones at joint margins (osteophytes), thickness of subchondral plate, and subchondral bone cysts (Dewing et al., 2012). Progression of osteoarthritis is characterized by vascular invasion and additional calcification of surrounding cartilage may take place. Huether & McCance (2013) state that bone inflammation is brought by vascular enlargement, abcess formation, leukocyte activity, and edema.
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that usually affects small joints in the feet and hands (Pfizer, 2016). Unlike osteoarthritis, rheumatoid arthritis is an autoimmune disorder whose initial causes are unclear though genetics and environmental factors may trigger it (McPhee & Hammer, 2010). After the initial immune response is triggered, immune system cells generate inflammatory cytokines and autoantibodies, which in turn develop a cascade of inflammation. The cascade contributes to pannus formation as the pannus attacks and destroys cartilage and bone. The process could contribute to more joint damage and systemic complications that emerge from a multifaceted process of inflammatory mediators that are released in the affected joint. Inflammatory that occurs in osteoarthritis is milder in severity in comparison to rheumatoid arthritis as genetics could result in the growth of both conditions.
Patient Factors
There are various patient factors that influence the pathophysiology, diagnosis, and treatment of osteoarthritis and rheumatoid arthritis. Some of these patient factors include gender and age. According to Dewing et al. (2012), individuals aged 65 years or more are increasingly vulnerable to osteoarthritis. The incidence or prevalence rates of this condition increases with age since older adults suffer from various musculoskeletal problems or conditions. Therefore, musculoskeletal conditions in old age contribute to the development of osteoarthritis. On the contrary, individuals who suffer from rheumatoid arthritis as usually younger than those who suffer from osteoarthritis. While rheumatoid arthritis occurs between 20 and 30 years, the incidence rates increases between 35 and 50 years. Rheumatoid arthritis can develop at any age since it is an autoimmune disorder that can be triggered by environmental factors. With regards to gender, women are more likely to develop osteoarthritis and rheumatoid arthritis unlike men (Dewing et al., 2012).
In light of these factors, women are more diagnosed with these two conditions unlike men. However, in relation to age, the diagnosis of osteoarthritis involves conducting a physical exam and examining patient history. Patient history is important in diagnosis of rheumatoid arthritis and is mostly combined with a physical exam, radiographs, laboratory tests, and other assessments. Regardless of gender and age, treatment of osteoarthritis is usually symptomatic while for rheumatoid arthritis, treatment focuses on preventing disease progression and destruction of joints. Nonpharmacologic therapy such as regular aerobic exercises are recommended for treatment since they help patients to maintain function and mobility.
In conclusion, osteoarthritis and rheumatoid arthritis are two common forms of arthritis, which is one of the most common chronic conditions in the United States. While these two conditions have some similar attributes, they differ in pathophysiology, diagnosis and treatment. The differences are attributable to the fact that osteoarthritis is a degenerative disorder while rheumatoid arthritis is an autoimmune disorder. The pathophysiology, diagnosis and treatment of these disorders is affected by different patient factors such as age and gender. Rheumatoid arthritis can develop at any age while osteoarthritis is common among older adults. However, women are at high risk of developing both conditions as compared to men.


References
Dewing et al. (2012). Osteoarthritis and Rheumatoid Arthritis 2012: Pathophysiology, Diagnosis, and Treatment. Retrieved December 8, 2018, from https://www.clinicaladvisor.com/features/osteoarthritis-and-rheumatoid-arthritis-2012-pathophysiology-diagnosis-and-treatment/article/265549/
Huether, S.E. & McCance, K.L. (2013). Alterations of Digestive Function in Children. In Understanding pathophysiology (5th ed.). Amsterdam, Netherlands: Elsevier.
McPhee, S.J. & Hammer, G.D. Inflammatory Rheumatic Diseases. In Pathophysiology of Disease (6th ed.). New York, NY: Mc-Graw Hill Medical.
Mobasheri, A. & Batt, M. (2016, December). An Update on the Pathophysiology of Osteoarthritis. Annals of Physical and Rehabilitation Medicine, 59(5-6), 333-339.
Pfizer. (2016, November 3). Rheumatoid Arthritis and the Value of Treatment. Retrieved December 8, 2018, from https://www.pfizer.com/files/health/VOMPaper_RheumatoidArthritis_11-3-2016.pdf