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Rheumatoid Arthritis and Osteoarthritis. D efinition A etiology P athophysiology S igns and Symptoms I nvestigations C omplications A lternative Diagnosis M anagement P rognosis. Definition.

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Rheumatoid arthritis and osteoarthritis

Rheumatoid Arthritis

and Osteoarthritis


Rheumatoid arthritis and osteoarthritis

Definition

AetiologyPathophysiologySigns and SymptomsInvestigationsComplicationsAlternative Diagnosis

Management

Prognosis


Definition
Definition

  • RA: - an autoimmune disease- results in a chronic, systemic inflammatory disorder - principally affects flexible (synovial) joints


Definition1
Definition

  • OA: - a degenerative non-inflammatory disorder- degradation of articular cartilage and subchondral bone- ‘wear and tear’- m/c affects the spine



Pathophysiology
Pathophysiology

  • RA: - not well understood- autoimmunity with environmental triggers- abnormal immune function response

  • OA:- chronic degenerative disorder- trauma

    - related to but NOT CAUSED by ageing

    H2O content of cartilage Cartilage is less resilient +- inflammation of joint capsule +- new bony outgrowths develop


Signs and symptoms of ra
Signs and Symptoms of RA

  • Joint: pain, stiffness, swollen, hot

  • Loss of joint function

  • Symmetrical polyarthritis

  • Pain worse in morning (>1hr)

  • Pain improves with movement

  • Fatigue

  • Anaemia of chronic disease


Signs and symptoms of oa
Signs and Symptoms of OA

  • Joint: pain, stiffness

  • Loss of joint function

  • NO swelling

  • Pain better with slight use but worse with excessive or prolonged movement

  • Crepitus


Investigations
Investigations

  • History and examination

  • X-ray

  • CT/MRI

  • Bloods

  • Assay analysis



Alternative diagnosis
Alternative Diagnosis

  • Gout

  • Pseudogout

  • SLE (RA)

  • Psoriatic arthritis

  • Reactive arthritis


Management of ra
Management of RA

  • Conservative: -Regular exercise - Patient education

  • Medical: - DMARDs - NSAIDs(+ after 3/12)

  • Surgical: - Arthroscopic/Open Synovectomy - Joint replacement - + Post-operative physiotherapy


Management of oa
Management of OA

  • Conservative: -Light exercise - Patient education - Weight loss if necessary

  • Medical: - Paracetamol - NSAIDs

  • Surgical: - Joint replacement


Prognosis
Prognosis

  • RA:- Progressive- Rh nodules  worse prognosis - Atherosclerosis- 3-12 year lifespan reduction

  • OA:- Progressive- Majority have no severe disability- Knee OA  worst prognosis- Hand OA  best prognosis