Osteoarthritis vs rheumatoid arthritis symptoms
In talkingabout the different symptoms between osteoarthritisand rheumatoid arthritis, I think my obsession with colorcoding will really pay off so we'll have red for rheumatoid arthritis and green for osteoarthritis. We'll talk about allthe different symptoms but I want to make thisa logical discussion so thinking back to thecause of these two diseases
and why it is that theyare different in symptoms. In rheumatoid arthritis, it'salways going to be autoimmune so the body's attacking itself, it's a whole body kind of process whereas in osteoarthritis,we're dealing with overuse. Usually in elderly people orpeople carrying extra weight weighing down their joints. Okay, first, before thedifferences, let's just quickly
go over the commonalitiesand why it's important to distinguish thembecause people will come in complaining of the same things. Pain, number one, their joints hurt. Both of these can be painful, they can also involve stiffness. The quality and timingwith it will be different but they'll both tell youthat their joints feel stiff
and they can't use them well. So with that, they mightavoid using their limbs, might lead to muscular weakness. Weakness, loss of function, and this weakness and loss of function and inability to do thethings they like to do might actually have indirecteffects on their mood, for example, depression is common
because both of these are chronic diseases so depression, risk for heart disease and other things froma sedentary lifestyle are all things to consider. So the point of this is whenpatients come in and tell you, quot;my joints hurt,quot; make sureto not leave it at that and keep asking the questionsto distinguish the two. The first question you mightask is, quot;Where does it hurt,
quot;which jointséquot; And here a very important featurethat distinguishes the two is gonna be the fact thatin rheumatoid arthritis, we have symmetry between the left side and the right side of the body. For example, when a personwith RA comes in and tells you, quot;my shoulders hurt,quot; it'sgoing to be shoulders, left and right.
Osteoarthritis vs rheumatoid arthritis pathophysiology
I thought aboutdrawing two different joints to show us the differencebetween rheumatoid and osteoarthritis. But then I thought showingit on the same picture might be easier to see the differences. But on this side we'll keepit rheumatoid arthritis, and the other side, green,will be osteoarthritis. Let's start with thepathophysiology of osteoarthritis
which is overuse. This is where elderlypeople, or people who are carrying a lot of extraweight, or have extra wear and tear on their jointstend to get osteoarthritis. And first thing's first, wehave our joint space here, this is a synovial joint, so it moves. These two bones move against each other. These are gonna be the bone parts.
We're not gonna do very much with them, we care about where they come together. This yellowish layer yousee here, is cartilage. It's kind of a cushionbetween the two bones. We don't want the two bonesto rub against each other. This soft, waxy cartilage,do rub against each other. Now over here we have the synovium, which is a very thin layer of tissue.
And its job is to produce synovial fluid, which is a lubricant of the whole system. Synovium if you look at the word, just as an extra trivia,syn means quot;similar toquot;, and ovium is referring tothe word quot;ovumquot; or quot;eggquot;. So synovial fluidsecreted by the synovium, is this whitish material,very, kind of like the consistency of egg whites.
I think that's where the word came from. Synovium, like egg whites. And that's all filled intheir joint space here, to lubricate the movementsbetween the two bones. So as you can imagine, thissystem allows the bones to move every whichway, gives us movement. Osteoarthritis if I had tosummarize it in two words, I would say it is cartilage destruction.
It is purely mechanical wear and tear of the cartilage layer, this cushioning. So we think of elderlypeople having this problem, but the truth is, thestate of one's cartilage is also genetic, some people have better or more cartilage to begin with. So the age issue aside,just think of it as the destruction ofcartilage layer with time.