Not All Arthritis Is Created Equal

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Are you having difficulty performing your usual daily activities because your joints ache? Are you experiencing stiffness that makes it difficult to get in and out of bed? If so, chances are you’re suffering from some form of arthritis. Arthritis is a non-specific term used to refer to joint pain and diseases and it encompasses more than 100 different forms. The two most common forms of arthritis are osteoarthritis (OA) and rheumatoid arthritis (RA). 

Osteoarthritis is the most common cause of chronic joint pain and affects an estimated 30 million people in the United States alone. Normally, cartilage, which is firm and flexible connective tissue, lines the ends of each bone in the body. Cartilage provides a cushion between bones and enables smooth gliding motions of the joints. In OA however, the cartilage breaks down and causes joint pain and swelling. In end stage disease, the cartilage is completely worn away and the two opposing bones rub against each other, leading to significant joint damage and pain.

While OA can affect any joint in the body, it most commonly affects the hands, spine, hips, and knees. There is currently no curative treatment for OA, however symptomatic management aims to decrease pain and increase an individual’s quality of life.

Signs & symptoms of OA include:

• Asymmetric joint involvement
• Joint pain which increases with activity
• Grating sensation with motion
• Tenderness over the joint

Diagnosis of OA includes:

• Detailed history and physical examination
• X-rays demonstrating: joint space narrowing and osteophyte formation

Management of OA includes:

• Weight loss
• Physical therapy/Occupational therapy
• Non-Steroidal

Anti-Inflammatory Drugs

• Cortisone Injections
• Gel Injections (often made with material from a roosters’ comb)
• Joint Replacement Surgery

Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Typically, the onset of joint pain and swelling occurs, slowing over weeks to months and can be associated with fevers, weight loss, and fatigue. In RA the synovium, the protective membrane that lines and provides nutritional support to the joint surfaces, is attacked by an accumulation of inflammatory cells. Inflammation in the joint spaces causes the synovium to thicken and thus destroy cartilage and bone within the joint. If left untreated, RA can cause debilitating joint deformities. Currently there are a variety of available therapies which help slow the progression of disease.

Signs and symptoms of RA include:

• Morning stiffness
• Symmetrical joint pain
• Joint swelling

Diagnosis of RA includes, but is not limited to:

• Morning joint stiffness lasting greater than one hour
• Swelling in at least three joints
• Symmetric arthritis
• Positive rheumatoid factor
• X-ray images demonstrating joint space narrowing and bony erosions
• Ultrasounds demonstrating inflammation of the joints

Treatment of RA includes:

• Non-Steroidal Anti-Inflammatory Drugs
• Oral Steroids
• Disease Modifying Anti-Rheumatic Drugs (Humira, Enbrel, Rituxan, etc.)

If you are suffering from arthritis and are looking to seek a medical evaluation, look no further than a rheumatologist. Rheumatologists are board certified physicians who specialize in the treatment of musculoskeletal disease and autoimmune conditions. Common diseases treated by rheumatologists are OA, RA, lupus, gout, scleroderma and more. Visit www.rheumatology.org/Directories/Find-a-Rheumatologist to find a specialist near you.

Katherine Alexis Athanasiou is a certified physician assistant (PA-C).

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