Osteoarthritis (OA) and rheumatoid arthritis (RA) share many similarities and differences in both their pathophysiology and the way they present clinically. OA is the most commo
Osteoarthritis (OA) and rheumatoid arthritis (RA) share many similarities and differences in both their pathophysiology and the way they present clinically. OA is the most common form of joint disease and has been commonly classified as noninflammatory joint disease (McCance & Huether, 2019). However, within the disease process it has been recently discovered that numerous cytokines, chemokines, prostaglandins, and apoptic molecules play an inflammatory role in the progression and development of OA (McCance & Huether, 2019). In OA, the cartilages of the joint become extremely thin over time and the resulting rubbing of the bones leads to unsteady gait, pain, and stiffness. Heberden and Bouchard nodes are both swelling deformities that can be seen in patients with OA as well. The only difference between them is that Heberden nodes are more distal interphalangeal and Bouchard nodes are proximal interphalangeal (Fernández-Ávila et al., 2018). OA is an age-related disorder; however, other risk factors include sedentary lifestyle, genetic factors, obesity, bone mineral density, injury, and gender (Bhatia et al., 2020). On the other hand, RA is a chronic, systemic inflammatory autoimmune disease that involves many tissues and organs but primarily affects the joints (McCance & Huether, 2019). The first joint tissue to be affected is the synovial membrane due to multiple immunoregulatory cytokines and inflammatory enzymes contributing to an exaggerated immune response which results in leukocyte infiltration into the synovium (McCance & Huether, 2019). The inflammation from the development of synovitis and joint damage could spread to the surrounding ligaments and cartilage causing pain, joint deformity, and loss of function (McCance & Huether, 2019). Some of the most common reported symptoms of RA include joint pain, joint swelling, joint stiffness, joint tenderness, joint warmth, muscle pain, and fatigue (Banderas et al., 2017). Unlike OA, RA does not only cause joint pain but organ and tissue damage as well. Major organs such as the lungs, heart, kidneys, and skin are impacted by RA. Another type of arthritis that stems from an accumulation of uric acid in the body fluids and in joints is gouty arthritis. Gouty arthritis differs from OA and RA in that the culprit of this disease process is hyperuricemia. Over time, crystals form from the uric acid and deposit in subcutaneous tissue forming white nodules called tophi which cause the joint pain that patients complain of (McCance & Huether, 2019). These three types of arthritis all have resemblances but each have a unique distinction in which to classify them. RA has an autoimmune inflammatory process whereas OA and gouty arthritis have, in general, more age-related joint damage.
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