the Differences Between Osteoarthritis and Rheumatoid Arthritis

Joint pain

Hello, Doctor! Since mid-August, I have been experiencing joint and bone pain that started with pharyngitis, and it has been over two months now.
I have consulted the immunology department at the Veterans General Hospital, and on October 13, I had blood and urine tests, which came back normal.
They initially diagnosed me with degenerative arthritis and mentioned that rheumatoid arthritis needs further monitoring.

Initially, I felt swelling and pain in my left ring finger (though there was no visible swelling), pain above my left knee, and then swelling in both hands.
The joints near the nails of my fingers and toes, as well as the area above my heels close to my ankles, feel prickly (but there is no visible swelling or inflammation).
I also experience muscle cramps in my calves, lumbar pain, and prickling sensations around my shoulder blades.
Currently, all of these symptoms occur, and in addition, my middle fingers on both hands become stiff in the morning for about 20 to 30 minutes.
As the evening progresses, my fingers, palms, elbows, and muscles become sore (occurring about 80% of the time).
Occasionally, the soles of my feet and my fingers (toes) also feel sore, and my knee joints hurt (without redness, swelling, or inflammation).
The pain seems to move around.
1.
What is the difference between degenerative arthritis and rheumatoid arthritis?
2.
Given that I feel the pain is becoming more frequent, could there be other underlying diseases?
3.
Should I seek further evaluation at another hospital, such as a neurology or orthopedics department, or another specialty? Thank you for your response, Doctor.

vicky, 30~39 year old female. Ask Date: 2007/10/29

Dr. Shi Guozheng reply Orthopedics

Degenerative arthritis typically occurs in middle-aged and older individuals, primarily affecting the large joints such as the knees, hips, and shoulders.
Additionally, the distal joints of the fingers may also be involved.
It generally presents with pain and deformity that develop gradually and is associated with injury or overuse.
Rheumatoid arthritis is an autoimmune disease that can affect both large and small joints, but it is more commonly symmetrical in presentation.
Symptoms include redness, swelling, heat, and pain, with a higher prevalence in females.
The rheumatoid factor (RF) in the blood may test positive.
If the pain progressively worsens, it could indicate other underlying conditions, and it is advisable to consult an orthopedic specialist.

Reply Date: 2007/10/29

More Info

Understanding the differences between osteoarthritis (OA) and rheumatoid arthritis (RA) is crucial for effective diagnosis and treatment. Both conditions can cause joint pain and discomfort, but they have distinct characteristics, underlying mechanisms, and treatment approaches.

1. Differences Between Osteoarthritis and Rheumatoid Arthritis:
- Nature of the Disease: Osteoarthritis is primarily a degenerative joint disease that results from wear and tear on the joints over time. It typically affects weight-bearing joints such as the knees, hips, and spine, as well as the hands. In contrast, rheumatoid arthritis is an autoimmune disorder where the immune system mistakenly attacks the synovial membrane, leading to inflammation in the joints. This condition often affects smaller joints, such as those in the hands and feet, and tends to occur symmetrically (i.e., the same joints on both sides of the body).

- Symptoms: OA symptoms usually include joint pain that worsens with activity and improves with rest, stiffness after inactivity, and potential swelling. RA symptoms, on the other hand, often include morning stiffness lasting more than 30 minutes, joint swelling, and systemic symptoms such as fatigue and fever. RA can also lead to joint deformities over time.

- Diagnostic Indicators: Blood tests can help differentiate between the two. In RA, tests may reveal the presence of rheumatoid factor (RF) or anti-citrullinated protein antibodies (anti-CCP). Imaging studies may show joint erosion in RA, while OA typically shows joint space narrowing and osteophyte formation.

2. Increasing Frequency of Pain: The increasing frequency of your joint pain could indicate a progression of your current condition or the development of another underlying issue. Conditions such as fibromyalgia, tendinitis, or even other autoimmune disorders could be contributing to your symptoms. It is essential to monitor these changes and discuss them with your healthcare provider, as they may warrant further investigation.

3. Consulting Other Specialists: Given the complexity of your symptoms and the potential overlap between different types of arthritis, it may be beneficial to consult with a rheumatologist if you haven't already. They specialize in autoimmune and inflammatory conditions and can provide a more comprehensive evaluation. Additionally, if you experience neurological symptoms (such as numbness or tingling), a consultation with a neurologist may be warranted. An orthopedic specialist could also be helpful if there are concerns about joint integrity or the need for surgical intervention.

In summary, while osteoarthritis and rheumatoid arthritis share some similarities in terms of joint pain, they differ significantly in their causes, symptoms, and treatment approaches. Given your symptoms and the complexity of your case, it is advisable to continue working closely with your healthcare providers to ensure an accurate diagnosis and appropriate management plan. Regular follow-ups and possibly additional testing will help clarify your condition and guide treatment effectively.

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