Arthritis vs Rheumatoid arthritis

What is arthritis and rheumatoid arthritis?

         Arthritis is a generalized term used to describe pain, stiffness, and inflammation of any joint. There are various types of arthritis such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, septic arthritis, gout and psoriatic arthritis. The most common are osteoarthritis and rheumatoid arthritis. When not specified arthritis refers to osteoarthritis or OA.

Difference in pathology

                    Osteoarthritis is a degenerative disorder in which the cartilage between the joints which acts as a cushion, wears off due to various reasons as a result of which, bones rub against each other giving rise to symptoms such as pain, stiffness, inflammation of joints, restriction of movements after physical activity and pain towards end of the day.

        Rheumatoid arthritis is an autoimmune disease, which means your body attacks itself. The Immune system produces antibodies that attack the joints and other parts of the body. Immune system sees the synovium (lining around the joints) as a threat similar to virus or bacteria and attacks it as a result of which fluid accumulates around the joints. This in turn causes pain, stiffness, inflammation and tenderness of joints. The autoimmune reaction of rheumatoid disease affects the entire body not just the joints. Early signs of rheumatoid arthritis are low grade fever, muscle pain, and fatigue. People in advanced stages of rheumatoid arthritis develop small lump like structure near joints called as rheumatoid nodules.

Difference in cause and symptoms

      Osteoarthritis normally affects weight bearing joints such as knee joint, hip joint and vertebral column whereas rheumatoid arthritis begins in smaller joints such as wrist joint, ankle joint, knuckles of fingers, toes and as disease advances it affects larger joints. Rheumatoid arthritis is a symmetrical disease that means you will experience symptoms on both sides of the body where as osteoarthritis occurs on any one side to begin with and eventually may spread to the other side of the body.

           The most characteristic symptom of rheumatoid arthritis is that symptoms worsen in the morning especially joint stiffness, which lasts for on average 20 to 30 minutes while in osteoarthritis, symptoms worsen towards evening.

Difference in diagnosis

            Diagnosis of arthritis is generally based on history and examination which helps to differentiate between types of arthritis. Investigations such as x-ray are helpful in both conditions. In case of rheumatoid arthritis, laboratory investigations such as elevated ESR levels, increased levels of C-reactive proteins and anti citrullinated antibody are done for confirming the condition.

Difference in treatment

        In severe cases of rheumatoid arthritis, if not treated early, deformities such as swan neck deformity, ulnar deviation, and boutonniere deformity might develop in the joints. There is no cure for arthritis and rheumatoid arthritis. Treatment depends on palliation. The main aim of the treatment is to reduce pain and inflammation to reduce suffering of the patient. Generally, non steroidal anti-inflammatory drugs (NSAIDs) are used to reduce pain along with local applications, orthopaedic bracing and physiotherapy.

       Physiotherapy helps in strengthening surrounding muscles by proper exercises. Life style modification such as weight reduction can also contribute to reduce pain. In severe cases of OA knees, total knee replacement surgery is considered.  In cases of rheumatoid arthritis along with NSAIDS , steroids are prescribed to reduce inflammatory process, disease modifying agents (DMARDs) such as chloroquine sulphate, folitrex and leflunomide are used.

SUMMARY:

        Arthritis is a common term used for pain, stiffness and inflammation of joints. There are various types of arthritis and rheumatoid arthritis is one of them. In rheumatoid arthritis, immune system attacks cells of one’s own body is called an autoimmune disorder. Arthritis  i.e. osteoarthritis normally affects larger joints where as rheumatoid arthritis affects smaller joints and body is symmetrically affected. Treatment is similar but there is no cure for either condition, just palliation of symptoms.

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