‘Arthritis’ is an umbrella condition that characterizes inflammation of one or more joints in the body.
This condition can be triggered by a number of different causes, including ‘wear-and-tear’ of the joints, obesity, and the body attacking its own immune system (autoimmune diseases).
Out of over 100 different types of arthritis, osteoarthritis and rheumatoid arthritis are two of the most common.
What is osteoarthritis?
Osteoarthritis is a type of arthritis commonly referred to as ‘wear-and-tear’ arthritis. This disease develops as cartilage breaks down, and the joints start to rub against each other over time. When cartilage (the flexible tissue that connects the joints) breaks down, the joints no longer have the padding they need to move and extend properly. This lack of support causes the synovial membrane (the membrane that surrounds the joint) to inflame.
As cartilage continues to wear down, the bones eventually rub against each other, which can cause severe joint pain, stiffness, and swelling. Although osteoarthritis can affect any joint, it frequently affects joints in the hands, neck, knees, and hips.
What is rheumatoid arthritis?
Rheumatoid arthritis, another common type of arthritis, is an autoimmune disease that affects the joints in the hands, elbows, knees, ankles, wrists, and feet. This form of arthritis can also damage the organs, as well as the respiratory system and the cardiovascular system, which is why this disease is considered a ‘systemic’ disease.
Rheumatoid arthritis is caused by the immune system attacking the synovial membrane. The immune system mistakes the synovial membrane for a foreign invader, attacking it as if it were an infection or virus. The cause behind this mistaken autoimmune attack is unknown.
What is the difference between osteoarthritis and rheumatoid arthritis?
The difference between osteoarthritis (OA) and rheumatoid arthritis (RA) is in the way these diseases harm the body. While OA is a degenerative disease caused by a physical breakdown of the cartilage, and eventually the bones, RA is an autoimmune disease caused by a reaction in the immune system.
Causes of OA and RA
Systemic Vs. Degenerative
Because RA is a systemic disease, it can attack multiple joints and areas of the body at the same time. A systemic disease is one that affects an entire bodily system at once, as opposed to affecting a single organ or area of the body.
When RA is present, a person’s immune system perceives their joints, the synovial tissues surrounding their joints, and other healthy organs as viruses or foreign invaders that need to be expelled from the body. In response to these invaders, the body’s white blood cells will rush to the site of the joint or organ, and create antibodies to destroy the perceived threat.
OA, on the other hand, is a degenerative disease and typically originates in a single joint. Unlike RA, this degenerative disease is non-inflammatory; it deteriorates (or degenerates) the connective cartilage between the joints, and eventually deteriorates the bones. OA is sometimes called ‘wear-and-tear’ arthritis because it results from natural aging and years of wear on the joints.
RA (a systemic disease) is caused by an autoimmune response, and OA (a degenerative disease) is caused by years of natural wear-and-tear.
Symptoms of OA and RA
Because OA and RA are caused by different factors, they elicit different symptoms.
A person who has rheumatoid arthritis may experience fatigue, malaise, and depression, preceding other symptoms by weeks to months. These are common symptoms of systemic diseases, as critical body systems, like the respiratory and cardiovascular systems, are under attack. These systems have key responsibilities in the body, and any damage to these systems can throw neurological, physiological, and physical functions off track.
Other symptoms of RA include:
- Low-grade fever
- Morning stiffness of the joints
- Swelling of the joints
- Pain in the joints and around the body
- Redness and warmth in the joints
- Weight loss
- Weakness of the muscles and joints
Osteoarthritis manifests differently around the body. Because this disease attacks the cartilage between joints, and not the bodily systems (like RA), symptoms are typically felt around the joints. Severe joint pain, stiffness and swelling are common, along with the following symptoms:
- Pain around the affected joint
- Weight-bearing joints “lock” or “give way”
- Morning stiffness
- Increased joint pain throughout the day
- Muscle weakness around the arthritic joint
- Deformed or ‘boney’ joints
- Cracking and popping of the joints
Diagnosis of OA and RA
The causes, symptoms, and treatment methods differ for OA and RA, so it’s important that we determine the type of arthritis a patient has in order for us to develop an effective treatment plan.
How Osteoarthritis is Diagnosed
Osteoarthritis is generally diagnosed through a series of tests, along with a physical examination and an assessment of past medical history.
Common tests used to diagnose OA include:
- Ultrasound to evaluate the ligaments and tendons around the affected joint
- Analysis of synovial fluid to determine whether degeneration is present
- Closed synovial biopsy to remove a piece of synovial tissue and assess its condition
- Arthroscopy examination of the joints through a small camera
- Arthrocentesis examination to remove joint fluid and assess its condition
How Rheumatoid Arthritis is Diagnosed
Rheumatoid arthritis is generally diagnosed through a series of tests, including physical examinations, blood tests, and x-rays.
If our rheumatology doctor, Dr. Maria Farooq, suspects rheumatoid arthritis, she will assess the affected joints to determine whether they are swollen, red, or warm, as these signs are indicative of RA. This physical exam may be followed by any of the following tests:
- Anti-cyclic citrullinated peptide (anti-CCP) test to identify auto-antibodies, called anti-CCPs
- C-reactive protein (CRP) test to identify c-reactive proteins that are produced in response to inflammation
- Rheumatoid factor (RF) test to measure levels of RF, an antibody often present when RA is present
- Erythrocyte sedimentation rate (ESR) test to identify elevated levels that are indicative of inflammation
- MRI and ultrasound tests to assess the joints
- X-rays to identify any damage on the joints
Treatment of OA and RA
How Osteoarthritis is Treated
Unfortunately, osteoarthritis cannot be reversed or treated. We offer various treatments and pain relievers to help patients with OA manage unpleasant symptoms.
- Intra-articular injections: Injections of corticosteroids, hyaluronic acid, BOTOX® or platelet-rich plasma (PRP) in the joints can help to relieve pain in the joints. These injections can provide the missing ‘cushion’ or padding that the cartilage once provided before it degenerated.
- Physical therapy: Because OA weakens the joints and muscles, physical therapy can help to strengthen the affected joints. Similarly, pain management classes can help patients to minimize the symptoms of OA.
- Pain-relieving medications: Various medications can be taken to relieve the symptoms of OA, dull the pain and discomfort, and reduce swelling. These medications include Tylenol® and NSAIDs (nonsteroidal anti-inflammatory drugs).
How Rheumatoid Arthritis is Treated
There is unfortunately no treatment to reverse rheumatoid arthritis either. We can provide various medications along with therapy to help patients manage the symptoms of RA.
- Disease-modifying medications: Various medications, known as DMARDs (disease-modifying anti-rheumatic drugs), can be taken to either slow the progression of RA or stop the progression entirely. These treatments can save the joints from further damage.
- Pain-relieving medications: Medications, such as NSAIDs and corticosteroids, can help to reduce swelling and inflammation and relieve the pain caused by RA. These medications can also help to improve physical function.
- Physical therapy: Physical therapy sessions can help patients to improve joint and muscle function. These sessions can also introduce patients to new ways of functioning or completing tasks to minimize joint pain.
Whether you know you have rheumatoid arthritis or osteoarthritis, or you’re experiencing symptoms of either, we offer advanced methods of diagnosis and treatment to assess your condition or help you manage your symptoms.
When you schedule an appointment with us at our UCF Rheumatology Services department, you can rest assured that we are dedicated to providing you with the highest quality of care, in a comfortable and welcoming environment.