Rheumatoid arthritis and osteoarthritis

Respond  on two different days who selected different factors than you, in one or more of the following ways:

Offer alternative diagnoses and prescription of treatment options for osteoarthritis and rheumatoid arthritis.

Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives.

Main Post

Rheumatoid arthritis and osteoarthritis both involve inflammation and affect the joints. Rheumatoid arthritis is a chronic systemic inflammatory disease characterized by the persistent symmetric inflammation of multiple peripheral joints (Hammer & McPhee, 2019). Osteoarthritis is characterized by local areas of loss and damage of articular cartilage, inflammation, new bone formation of joint margins, subchondral bone changes, variable degrees of mild synovitis, and thickening of the joint capsule (Huether & McCance, 2017).

Pathophysiology

Osteoarthritis is most commonly from wear and tear of the cartilage around the joint; this can be enhanced form sports or overuse at a particular occupation. Pro-inflammatory factors are released, and catabolic activation begins resulting in a net degradation of cartilage extracellular matrix (Esa et al., 2019). The cartilage becomes and may be absent over some areas, leaving the bone unprotected (Huether & McCance, 2017). Rheumatoid arthritis pathophysiology involves the destruction of the synovial linings that protect the joints; these linings provide nutrients and lubrication for the articular cartilage. Hammer and McPhee (2019) explain that enhanced pro-inflammatory cytokine production is a dominant feature of rheumatoid arthritis.

Gender and Ethnicity’s Impact

Rheumatoid arthritis is most typically a persistent, progressive disease presenting in women in the middle years of life (Hammer & McPhee, 2019). Studies have shown that hormones play a role in the development of rheumatoid arthritis, specifically when women are undergoing hormonal changes at childbirth and menopause. All these phenomena have in common an acute decline in ovarian function and/or in oestrogen bioavailability (Alpízar-Rodríguez, Pluchino, Canny, Gabay, & Finckh, 2016). The peak incidence in females coincides with menopause when the ovarian production of sex hormones drops markedly (Karsdal, Bay-Jensen, Henriksen, & Christiansen, 2012). No evidence supports that ethnicity is a factor in rheumatoid arthritis. Several studies performed, but due to their limitations and sample sizes, they could not be validated.

Although osteoarthritis incidence rates are quite similar in men and women, after age 50, women typically are more severely affected (Huether & McCance, 2017).  Following the same pattern as rheumatoid arthritis with menopausal and post-menopausal women. Several experimental studies have shown that estrogens are implicated in the regulation of cartilage metabolism (Mahajan & Patni, 2018). Again for osteoarthritis, no research clearly recognized that ethnicity enhanced the disease process.

Conclusion

Both osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis that affect millions of people. The symptoms can be very similar, and a thorough examination should be done to distinguish between the two. Osteoarthritis usually affects one joint, while rheumatoid arthritis affects several joints at once.

References

Alpízar-Rodríguez, D., Pluchino, N., Canny, G., Gabay, C., & Finckh, A. (2016). The role of female hormonal factors in the development of rheumatoid arthritis. Rheumatology. https://doi-org.ezp.waldenulibrary.org/10.1093/rheumatology/kew318

Esa, A., Connolly, K., Williams, R., & Archer, C. (2019). Extracellular Vesicles in the Synovial Joint: Is there a Role in the Pathophysiology of Osteoarthritis? Malaysian Orthopaedic Journal, 13(1), 1-7. https://doi-org.ezp.waldenulibrary.org/10.5704/MOJ.1903.012

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Karsdal, M. A., Bay-Jensen, A. C., Henriksen, K., & Christiansen, C. (2012). The pathogenesis of osteoarthritis involves bone, cartilage and synovial inflammation: may estrogen be a magic bullet? Menopause International, 18(4), 139–146. https://doi-org.ezp.waldenulibrary.org/10.1258/mi.2012.012025

-org.ezp.waldenulibrary.org/10.4103/jmh.JMH_157_18doi(4), 171. https://9 Journal of Mid-life Health,, R. (2018). Menopause and Osteoarthritis: Any Association? Patni, A., & Mahajan

 

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