Rheumatoid arthritis & Osteoarthritis
Types, causes, symptoms, complications, diagnosis and treatment

What is arthritis?

Arthritis is a group of conditions that affect the joints and their surrounding tissues. Arthritis is frequently accompanied by joint pain (arthralgia) and swelling (inflammation) of the joint.

A joint is the meeting point of two separate bones, this junction is cushioned by a soft structure called the cartilage. Arthritis can affect joints in the wrists, fingers, elbows, knees, toes. 

What is juvenile arthritis?

Juvenile arthritis is observed in children of age below 16 years who develop swelling (inflammation) of joints and their surrounding tissues including the synovium. This is an autoimmune disease without any known exact cause. It is related to genetics, environmental factors, and infections.

Children with juvenile arthritis may or may not have symptoms. Some of the commonly noticed symptoms include joint stiffness, pain, swelling, limping, persistent fever, rash, irritability, tiredness and vision problems.

What is osteoarthritis?

Osteoarthritis (OA) is a type of arthritis that involves the joints of the knees, lower back, small joints of the fingers and hands, hips and the neck. It is a painful condition that occurs because of degeneration of cartilage due to wear-and-tear within these joints. Some of the causes of wear and tear are:

• Advancing age
• Overuse as in repetitive movements like holding objects like scissors or racquet in particular professions like tailors and players
• Excess weight in obese patients

What is rheumatoid arthritis?

Rheumatoid arthritis is a chronic autoimmune disease that results from overactive immune response to the body’s own tissues, in this case, joints. Rheumatoid arthritis can affect the tissues in other organ systems also, such as the heart, lungs, skin and blood vessels.

While Osteoarthritis is associated with wear-and-tear, rheumatoid arthritis causes swelling and bone erosion and joint deformity. Furthermore, the resultant inflammation causes damage to the nearby tissues.

As against osteoarthritis which is usually seen in elderly, rheumatoid arthritis may be seen in children of age 16 or younger. This condition is called as Juvenile rheumatoid arthritis.

The pain and discomfort may begin at the smaller joints in fingers and toes, and as the disease progresses the symptoms extend to the wrists, ankles, knees, elbows, hips and shoulders. Eventually, when left untreated, the joints may deform and shift out of place.

What are the causes of arthritis?

Based on the form of arthritis, the causes and progress of arthritis vary.

• Degeneration of tissues causes osteoarthritis, which may be exacerbated by an injury or infection. Altogether, in osteoarthritis, the cartilage (flexible supporting and shock absorbing tissues in the joints) undergoes slow, natural breakdown due to wear-and-tear and pose increased mechanical stress (pressure and shock) to the joints.
• Auto-immune response against synovium (tissue lining around joints) in the joints results in poor lubrication of joints and nourishment to cartilage. Eg. Rheumatoid arthritis
• Inflammatory response against the joints causes inflammatory arthritis, such as psoriatic arthritis, spondyloarthritis.
• Metabolic abnormalities such as gout (high levels of uric acid) lead to gouty arthritis.
• Infections such as salmonella, shigella, hepatitis C, chlamydia, gonorrhea are related to joint inflammation. Untreated joint infections can cause longstanding damage.

What are the symptoms of osteoarthritis?

Some common symptoms of osteoarthritis are:

• Pain, tenderness and stiffness
• Audible crunching/grating sensation caused by rubbing together of bones
• Bone spurs (extra bone growth)
• Immobility of the joint
• Pain that worsens following exercise
• Reduced flexibility in the joint

Treatment for Osteoarthritis

What are the symptoms of rheumatoid arthritis?

Some common joint-related symptoms of rheumatoid arthritis include:

• Pain, tenderness and stiffness
• Swelling and even distortion of the joint
• Stiffness leading to reduced movement and function

In Rheumatoid arthritis, along with the symptoms related to joints, the patient may experience the symptoms related to skin, eyes, lungs, heart, kidneys, salivary glands, nerve tissue, bone marrow and blood vessels.

• Anemia
• Tiredness
• Fever
• Inflammation of eyes
• Inflammation of the lung
• Nodules under the skin
• Weight loss

What are the risk factors for arthritis?

The risk factors for arthritis are –

Age – The risk for degenerative arthritis (osteoarthritis), increases with age.

Genetics and family history – Most types of arthritis are inherited, a strong family history increases the risk.

Gender – Women are more prone to many forms of arthritis, however, gouty arthritis is more common in men.

Body weight – Above normal body weight increases the chances of wear-and-tear of the joints.

Smoking – Smoking increases the risk for and severity of rheumatoid arthritis, particularly when the patient is predisposed genetically.

Occupational factors – Jobs involving repetitive movements increase the risk of osteoarthritis.

Bone deformities – Malformed joints and defective cartilage increase the risk of osteoarthritis.

What are the complications of osteoarthritis and rheumatoid arthritis?

Osteoarthritis is a degenerative joint disease which can be debilitating. An orthopedist may advise joint replacement for severe joint pain and stiffness, such as knee replacement surgery (for knee arthritis) and hip replacement surgery (for hip arthritis).

Other than the progressive deterioration of joints, complications of rheumatoid arthritis are –

• Osteoporosis
• Rheumatoid nodules
• Dry eyes and mouth
• Carpal tunnel syndrome
• Heart problems
• Lymphoma
• Lung disease
• Abnormal body fat composition even with normal BMI
• Increased risk for infections

How is arthritis diagnosed?

Arthritis may be diagnosed with the following tests –

• Detailed medical history
• Medical examination
• Blood tests: C-reactive proteins (an indicator of inflammation)
• Imaging tests: X-ray, Magnetic resonance imaging (MRI) and ultrasound
• Joint aspiration test

How is rheumatoid arthritis treated?

The healthcare team of rheumatologist, orthopedist and surgeon treats arthritis with one or a combination of –

• Medications:
  • – Painkillers
  • – Steroids
  • – Anti-rheumatic medications
• Physiotherapy
• Surgery:
  • – Synovectomy
  • – Tendon repair
  • – Joint fusion
  • – Total joint replacement

How is osteoarthritis treated?

Management of osteoarthritis is aimed at relieving symptoms and assuring the routine functioning of the joints. 

The modes of treatment are:

• Medications:
  • – Pain management with medications like painkillers or topical creams.
• Physiotherapy:
  • – Appropriate exercises or physical therapy, as advised by an orthopedist.
• Surgery:
  • – Joint splinting
  • – Knee or hip replacement
  • – Bones realignment
  • – Lubrication injections (Hyaluronic acid)
  • – Cortisone injections

Treatment for Osteoarthritis

What is arthritis diet?

Focusing on what you eat can make a lot of difference. Avoiding or limiting the triggers and taking anti-inflammatory diet can help manage symptoms of arthritis better.

Talk to your dietitian for a diet plan which focuses on

• Weight management
• Metabolic conditions such as gout
• Including anti-inflammatory foods
• Bone and joint strengthening

How to manage arthritis at home?

• Exercise regularly
• Hot and cold packs
• Normalize body weight
• Use braces or shoe inserts
• Knee taping to ease pain from knee osteoarthritis.
• Use assisting devices such as a cane (while walking), gripping or grabbing tools (for arthritis in fingers).

To know more about arthritis and osteoporosis, you can request a callback and our Rheumatoid arthritis & Osteoarthritis specialists will call you and answer all your queries.

References

• National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis and Arthritis: Two Common but Different Conditions. Available at: https://www.bones.nih.gov/health-info/bone/osteoporosis/conditions-behaviors/osteoporosis-arthritis. Accessed on 28th December 2017.
• Mayo Clinic. Rheumatoid arthritis. https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648. Accessed on 19th May 2018.
• Mayo Clinic. Osteoarthritis. https://www.mayoclinic.org/diseases-conditions/osteoarthritis/symptoms-causes/syc-20351925. Accessed on 19th May 2018.

Disclaimer:

“The content of this publication has been developed by a third party content providerwho are clinicians and/or medical writers and/or experts. The information contained herein is for educational purpose only and we request you to please consult a Registered Medical Practitioner or Doctor before deciding the appropriate diagnosis and treatment plan.”