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1.         Compare and contrast the causes, signs and symptoms, and treatments of osteoarthritis and rheumatoid arthritis.

Jul 29th, 2015

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  1. The main difference between osteoarthritis and rheumatoid arthritisis the cause behind the joint symptoms. Osteoarthritis is caused by mechanical wear and tear on joints. Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints

  2. Comparison chart

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Rheumatoid Arthritis

Presence of symptoms affecting the whole body (systemic)Systemic symptoms are not present. Localized joint pain (Knee and hips) but NO swelling Pain severity is important (mechanical, inflammatory, noctornal, sudden)Dull pain and inflammation Frequent fatigue (afternoon), stiffness, ulnar deviation, muscle atrophy, swelling of the knuckles , synovial Thickness complications: joint fail, depression, Osteoporosis, infections surgical complications
TreatmentNSAIDs (short term use)Acetaminophen, Analgesics, exerciseNSAIDs, Steroids (Prednisone), DMARDs (Methotrexate), Antimalarial (Plaquenil), Corticosteriods,
Associated symptoms(no systemic symps) fatigue, muscle weakness, fever, organ involvement; Bony enlargement, deformity, instability, restricted movement, joint locked, sleep dist,depression, comorbid conditions (bursitis, fibromyalgia, gout)Frequent feelings of "being sick inside," with fevers, weight loss, or involvement of other organ systems. carpal tunnel Extra-articular manifestations: nodules, vasculitis, pulmonary, cardiac, skin (vasculitis), eye (sjorgen's syndrome, scleritis
Diagnosisx-ray, pain assessment- perarticular and articular source of pain, presence of deformity, evidence of muscle wasting, local inflammation. asymmetrical joints1- Anemia (ferratin, ion. ion binding capacity) 2- bone (inc ALP) 3- Inflammatory markers (C reactive protein and ESR)
Disease ProcessNormal wear and tear (chronic degenerative)chronic Autoimmune
GenderCommon in both men and women. Before 50 more men than women, after 50 more women than menAffects more women than men
Effusionslocal inflammation/effusion sometimesCommon
NodulesHerberden's & Bouchard's nodesPresent, especially on extensor surfaces. Swan neck deformity. Biopsy important to eliminate gouty tophi
Pattern of joints that are affectedAsymmetrical & may spread to the other side. Symptoms begin gradually and are often limited to one set of joints, usually the finger joints closest to the fingernails or the thumbs, large weight-bearing joints,Symmetrical - often affects small and large joints on both sides of the body, such as both hands, both wrists or elbows, or the balls of both feet,
Age of onsetOver 6035-45 years old
SeverityLess severeMore severe
Speed of onsetSlow, over yearsRapid, within a year
Causewear and tear associated w/ aging or injury, also caused by injuries to the joints, obesity, heredity, overuse of the joints from sportsClassified as an autoimmune disease, No real known cause.-Connection between environmental and genetic factors;female reproductive hormones
Joint symptomsJoints painful but without swelling; affects joints asymmetrically; affects bigger joints such as hips & knees. Localized with variable, progressive courseJoints are painful, swollen, and stiff; affects joints symmetrically; affects smaller joints such as hands & ankles. Systemic with exacerbations and remissions
pain w/ movementmovement increases painmovement decreases pain
AssessmentOne or several joints; enlarged, cool, and hard on palpation;Joints are swollen, red, warm, tender, and painful;several joints involved; Extraarticular: Rheumatoid nodules, Sjogrens sydrome, Felty syndrome
Radiologic findingsLoss of joint space and articular cartilage, routine wear and tear osteophytes, sclerosis, cysts, loose bodies, alignmentBony erosions, soft tissue swelling, angular deformities,
Lab findingsRheumatoid Factors (RF) negative, transient elevation in ESR related to synovitisRF positive, increased ESR & CRP, antinuclear antibody, arthrocentesis
Genetic FactorsFamily HX of OA-womenmRA and Leukocyte antigen- female reproductive hormones, Epstein-Barr virus
Interdisciplinary Teamcollaborate with PT to provide heat or cool packs, positioning, and mobility,Helps control the diseas and decrease intensity and number of exacerbations
Patient EducationKeep weight within normal limits, assist with smoking cessation, avoid risk taking activities, avoid/limit participation in recreational sports, wear supportive shoes, do not perform repetitive exercises.

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Jul 29th, 2015

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