OA vs Rheumatoid arthritis

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    Lately I have been curious regarding the difference between osteoarthritis and rheumatoid arthritis I noticed that a lot of my patients are diagnosed with OA rarely anyone is thought to have RA, I noticed that symptoms are similar for OA and RA, a lot of my OA patient tells me their knees are swollen and painful, but redness and edema and pain is often a major symptom of RA, are they misdiagnosed or have both, how do you truly distinguish between those two different type of Arthtitis, it is mind bogging...
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    I think osteo is due to overuse of the joints or from athletics whereas rhuematoid is an autoimmune disorder. There are blood tests that can test for RA. It is in the same category and often misdiagnosed with lupus. The patients need to see a rheumatologist to be properly tested and diagnosed. Some with RA also get psoriasis whereas lupus can have a rash as well. I am not an expert so I apologize if this is vague. I have a family member with RA and she is always getting sent from one dr to the next with little relief.
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    OA- mechanical
    RA- autoimmune
    Both involve joints, motion, and "use" trauma.
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    I must add, I would not wish RA on anyone. Looks terribly painful.
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    Quote from MJB2010
    I must add, I would not wish RA on anyone. Looks terribly painful.
    First person I remember seeing w/RA was a 7 year old kid.... I was 8... It was really sad. She did really well, though I don't know what happened to her. She was in one of the 'umbrella' strollers when she had bad days; otherwise, she sort of hobble-limped. It was really sad- but the kid enjoyed what she could.
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    OA is typically unilateral.
    RA is usually symmtetrical, typically to the small joints.
    X-rays, physical exam and serological tests (RA factor, CRP and others) are used make the diagnosis. In the early part of the disease it's usually difficult to differentiate between the two. Sero-negative serum studies and unitlateral findings make the two difficult to differentiate.

    However, what you really want to know is if you're patient is responding to treatment. NSAID's are a logical place to start. If the patient responds well to treatment, continue with it. If the patient doesn't, alternative treatment should be sought. And yes, if RA is in question but not clearly diagnosed, a rheumatologist should be consulted.
    GrnTea and Hospice Nurse LPN like this.
  9. 3
    As others have said, you can think of OA as "wear and tear" but RA is autoimmune and varies in how quickly it progresses. RA can "turn on" in childhood, or after serious illness or even pregnancy -- its not just for the elderly. RA can also affect the person internally - lungs, heart. The damage of RA is cumulative and crippling, so it must be aggressively treated with immunosuppressants. Most patients with RA will be on 20mg of oral/injectible methotrexate once a week, daily folic acid, and an anti-tnf injectible medication (such as Enbrel/Humria) or infusion. Some more severe cases will be on multiple immunosuppressants. Methotrexate and many of the other medications for RA require routine bloodwork every few months to ensure no liver damage. As long as a patient is compliant with medications and has good communication with their doctor, most can reduce the frequency of pain/inflammaton/swelling 'flare ups' and can have many more healthy joint years.

    The majority of people with RA can be diagnosed by history and bloodtests such as rheumatoid factor and anti-ccp antibody, but some people are "seronegative". These people will display the signs of RA and will show marked improvement on the RA medications before being given the final diagnosis of "seronegative RA".
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    and then you have the famous third form of RA, such as fibromyalgia which I always thought more of as a "muscle" disease rather than a type of RA, which can affect the chest, low back, arms, hips, tighs and neck and which may require different type of treatment drugs
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    Quote from Blackheartednurse
    and then you have the famous third form of RA, such as fibromyalgia which I always thought more of as a "muscle" disease rather than a type of RA, which can affect the chest, low back, arms, hips, tighs and neck and which may require different type of treatment drugs
    I'm not entirely sure what you mean, there's multiple types of arthritis but fibromyalgia is not rheumatoid arthritis. You would not give immunosuppressants to someone with fibromyalgia.
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    I was just diagnosed with RA back in May (crp and sed rate to confirm). It is a genetic autoimmune disease that can affect not only the joints (mainly toes, knees, hips, hands, wrists, shoulders, and neck), but the major organs as well (heart, lungs). It also causes extreme fatigue. It is treated with anti-inflammatory drugs and immunosuppressants. This is to help slow the irreversable damage done to the joints.

    So far, I am only exhibiting symptoms such as fatigue, daily joint pain. I once took care of a patient who had severe RA and had to have numerous surgeries to fuse bones in her ankles and her hands had become extremely distorted to the point that she really had no use of her extremities. It was frightening. I am actually really concerned because I am only 43 yrs. old. I have not been to RA doc, but my appt is on Monday, 10/31. I'll keep you posted.

    P.S. My mother has it, but she was not diagnosed until 5 yrs. ago (60 yrs. old). Hope this helps to answer your question.


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