Osteoarthritis vs Rheumatoid Arthritis

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The symptoms and treatment for rheumatoid arthritis (RA) and osteoarthritis are different, and an accurate diagnosis is important for the patient's health. RA is an autoimmune disease where the immune system attacks healthy tissues in the body. Meanwhile, osteoarthritis is caused by aging and regular wear and tear of the body.

Comparison chart

Osteoarthritis versus Rheumatoid Arthritis comparison chart
	Osteoarthritis	Rheumatoid Arthritis
Presence of symptoms affecting the whole body (systemic)	Systemic symptoms are not present. Localized joint pain (Knee and hips) but NO swelling Pain severity is important (mechanical, inflammatory, noctornal, sudden)	Dull pain and inflammation Frequent fatigue (afternoon), stiffness, ulnar deviation, muscle atrophy, swelling of the knuckles , synovial Thickness complications: joint fail, depression, Osteoporosis, infections surgical complications
Associated symptoms	(no systemic symps) fatigue, muscle weakness, fever, organ involvement; Bony enlargement, deformity, instability, restricted movement, joint locked, sleep dist,depression, comorbid conditions (bursitis, fibromyalgia, gout)	Frequent feelings of "being sick inside," with fevers, weight loss, or involvement of other organ systems. carpal tunnel Extra-articular manifestations: nodules, vasculitis, pulmonary, cardiac, skin (vasculitis), eye (sjorgen's syndrome, scleritis
Joint Symptoms	Joints painful but without swelling; affects joints asymmetrically; affects bigger joints such as hips & knees. Localized with variable, progressive course	Joints are painful, swollen, and stiff; affects joints symmetrically; affects smaller joints such as hands & ankles. Systemic with exacerbations and remissions
Treatment	NSAIDs (short term use) Acetaminophen, Analgesics, exercise	NSAIDs, steroids (prednisone), DMARDs (Methotrexate), antimalarial (Plaquenil), corticosteriods
Diagnosis	x-ray, pain assessment- perarticular and articular source of pain, presence of deformity, evidence of muscle wasting, local inflammation. asymmetrical joints	1- Anemia (ferratin, ion. ion binding capacity) 2- bone (inc ALP) 3- Inflammatory markers (C reactive protein and ESR)
Disease Process	Normal wear and tear (chronic degenerative)	chronic Autoimmune
Gender	Common in both men and women. Before 50 more men than women, after 50 more women than men	Affects more women than men
Cause	wear and tear associated w/ aging or injury, also caused by injuries to the joints, obesity, heredity, overuse of the joints from sports	Classified as an autoimmune disease, No real known cause.-Connection between environmental and genetic factors;female reproductive hormones
Pattern of joints that are affected	Asymmetrical & may spread to the other side. Symptoms begin gradually and are often limited to one set of joints, usually the finger joints closest to the fingernails or the thumbs, large weight-bearing joints,	Symmetrical - often affects small and large joints on both sides of the body, such as both hands, both wrists or elbows, or the balls of both feet
Age of onset	Over 60	35-45 years old
Speed of onset	Slow, over years	Rapid, within a year
Effusions	local inflammation/effusion sometimes	Common
Nodules	Herberden's & Bouchard's nodes	Present, especially on extensor surfaces. Swan neck deformity. Biopsy important to eliminate gouty tophi
Severity	Less severe	More severe
pain w/ movement	movement increases pain	movement decreases pain
Assessment	One or several joints; enlarged, cool, and hard on palpation;	Joints are swollen, red, warm, tender, and painful;several joints involved; Extraarticular: Rheumatoid nodules, Sjogrens sydrome, Felty syndrome
Radiologic findings	Loss of joint space and articular cartilage, routine wear and tear osteophytes, sclerosis, cysts, loose bodies, alignment	Bony erosions, soft tissue swelling, angular deformities
Lab findings	Rheumatoid Factors (RF) negative, transient elevation in ESR related to synovitis	RF positive, increased ESR & CRP, antinuclear antibody, arthrocentesis
Genetic Factors	Family HX of OA-womenm	RA and Leukocyte antigen- female reproductive hormones, Epstein-Barr virus
Interdisciplinary Team	collaborate with PT to provide heat or cool packs, positioning, and mobility,	Helps control the disease and decrease intensity and number of exacerbations
Patient Education	Keep weight within normal limits, assist with smoking cessation, avoid risk taking activities, avoid/limit participation in recreational sports, wear supportive shoes, do not perform repetitive exercises.	Healthy nutrition, report ASE from medication use, teach that RA is systemic and effects many body systems.

Cause

Rheumatoid arthritis (RA) is a disease in which your own immune system mistakenly attacks healthy tissue, causing inflammation that damages your joints. No single cause for RA has been found; current theory suggests patients are genetically predisposed to the disease.

On the other hand, Osteoarthritis (OA) is not an autoimmune disease. It is a condition of wear and tear associated with aging or injury. The immune system is not affected. Common causes for OA include joint injury, repetitive strain/use, being overweight as well as genetic predisposition.

Signs and symptoms

RA usually causes pain or stiffness lasting for more than 30 minutes in the morning or after long rest and lack of activity. OA stiffness tends to get worse with use throughout the day.
RA is associated with symmetrical swelling e.g., both hands, both elbows, etc. whereas OA is associated with asymmetrical (not "matching") swelling in individual joints that are not part of a pair — e.g., one knee and an elbow, instead of both knees
Most typically, RA symptoms include joint pain, swelling, tenderness, and redness of the joints; prolonged morning stiffness; and less range of movement. Some people also experience fever, weight loss, fatigue, and/or anemia Generally, OA symptoms include joint stiffness, pain, and enlarged joints and it does not have any systemic symptoms.
RA tends to cause swelling and pain in smaller joints such as the hands and ankles while OA tends to cause pain and swelling in bigger joints such as the hips and knees.

Location of joints involved

With RA, inflammation generally occurs in the knuckles and at the joints closest to your hands, nearer the base of your fingers. On the other hand with OA, inflammation generally occurs at the joint closest to your fingernail.

Prevalence

OA is much more common than RA. In the United States alone, an estimated 20 million people have osteoarthritis, and approximately 2.1 million people have RA.