Osteoarthritis and Rheumatoid arthritis both affect your joints. Both have “arthritis” as a suffix, but these two are different. “Arthritis” is an umbrella term for inflammation. Osteoarthritis is a primary degenerative disorder caused by wear and tear of articular cartilages, whereas Rheumatoid arthritis is an autoimmune disorder when the host’s immune system attacks the tissues around the joint.
Degenerative OA Vs Autoimmune RA
Osteoarthritis (OA) is a chronic degenerative disorder that primarily affects the articular cartilage of the joints. It also involves bone remodelling and overgrowth at the margins of the joint in the form of spurs. OA leads to activity limitation and reduced participation. Prolonged mechanical stress, muscle weakness, overweight, are possible causes of OA.
OA is classified into 4 grades.
| Stage 1 | Minor: Normal No joint space reduced. | Minor wear and tear in the joints. Little to no pain in the joints. | |
| Stage 2 | Mild: Normal Joint space. | Noticeable bone spurs in the joints. The joint becomes stiff and painful after prolonged rest periods. | |
| Stage 3 | Moderate: Moderate Joint space reduction. | Cartilage begins to erode. The joint becomes inflamed and causes pain even in simple activities like standing or walking. | |
| Stage 4 | Severe: Severe Joint space reduction. | Cartilage is almost worn off leading to an inflammatory response at the joint. Overgrowth of bony spurs and a lot of pain. |
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune, inflammatory, systemic, long term disorder that affects the synovial linings of joints and other connective tissues. RA is characterised by fluctuations between active disease and remissions.
Classical symptoms of RA include Aching joints, stiffness and abrupt swelling, progressive deformities. The disease is characterised by symmetrical deformities in both limbs.
Onset is usually in the smaller joints of the hands and feet and most commonly the smaller joints at fingers (proximal interphalangeal joints). Pain is usually felt and muscle atrophy and weakness follows.
Deformities involved in RA:
- Boutonniere Deformity: It is a deformity of the fingers in which the proximal interphalangeal joint (PIP) is flexed and the distal interphalangeal joint (DIP)
- Swan-neck Deformity: Characterized by proximal interphalangeal (PIP) joint hyperextension and distal interphalangeal (DIP) joint flexion.
- Ulnar deviation: Ulnar deviation at the fingers (metacarpophalangeal joints) is seen.
Comparison Of OA and RA
| Osteoarthritis | Rheumatoid Arthritis | |
|
Usually after 40 years of age. | Usually begins between 15-50 years of age. |
|
Slowly in response to mechanical stress. | Sudden, within weeks or months. |
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Reduced joint space, worn-out cartilage, osteophyte formation. | Deformities such as Boutonniere deformity, Swan-neck deformity, etc. |
|
Morning stiffness and joint pain with weight-bearing. | Prolonged morning stiffness, tiredness, weakness, redness, warmth, swelling. |
|
Joints of Hands, Lumbar spine, Hips, Knees, Feet (1st Thumb) | Smaller joints of hands and legs, symmetrical, bilaterally. |
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