Rheumatoid Arthritis vs. Osteoarthritis

Rheumatoid arthritis is a complex disease with varying symptoms and complications that differ for each patient. Often times, rheumatoid arthritis symptoms are confused with osteoarthritis symptoms. This confusion happens commonly during the first signs of arthritic symptoms.

Despite the fact that both are types of arthritis cause joint pain, the two disease have different diagnoses. Interestingly, though the two are chronic and non-curable disease, they are completely separate conditions with different causes, symptoms, prognoses, and treatments.

Rheumatoid Arthritis vs. Osteoarthritis: Disease

The primary difference between rheumatoid arthritis and osteoarthritis is the nature of the disease. Rheumatoid arthritis is an autoimmune disorder that produces inflammatory joint symptoms throughout the body. Osteoarthritis is a degenerative condition that is the result of increased wear and tear on joints. Osteoarthritis may produce inflammatory symptoms as well but primarily destroys joint cartilage over time.

Osteoarthritis affects an estimated 27 million Americans while only 1.3 million Americans have rheumatoid arthritis. Both rheumatoid arthritis and osteoarthritis are more prevalent in women than in men. Rheumatoid arthritis can develop in patients anytime between the ages of 30 and 60 years old. Osteoarthritis generally develops later in life.

Rheumatoid Arthritis vs. Osteoarthritis: Causes

Rheumatoid arthritis and osteoarthritis are caused by different issues with different risk factors. This is what makes the two types of arthritis diseases primarily different.

Osteoarthritis Causes

Osteoarthritis is caused by continued wear and tear on specific joints in the patient’s body. It is a chronic condition that can get worse with age. Certain jobs or sports that involve repetitive motions can also lead to developing osteoarthritis. These activities place additional pressure on joints which may continue to wear down the cartilage. Old injuries or ones that didn’t heal properly can also increase the risk of developing osteoarthritis.

There is also a potential genetic risk factor associated with osteoarthritis whereby it’s possible to inherit cartilage deterioration.

Rheumatoid Arthritis Causes

The exact cause of rheumatoid arthritis is unknown at this time. Doctors do know that rheumatoid arthritis is triggered by an autoimmune disorder whereby harmful antibodies are produced that attack the healthy joint tissue in patients. What causes the autoimmune disorder to develop in certain patients is unknown.

The primary risk factors for triggering rheumatoid arthritis are thought to be genetic, environmental, hormonal, and even certain lifestyle factors like smoking and obesity. Rheumatoid arthritis affects patients from a variety of backgrounds and so it is difficult to determine one specific cause.

Rheumatoid Arthritis vs. Osteoarthritis: Symptoms

Rheumatoid arthritis symptoms have a rather rapid onset where the condition can worsen in a matter of weeks. Osteoarthritis symptoms slowly develop and gradually worsen over a long period of time.

Rheumatoid arthritis symptoms affect joints all the over the body including hands, fingers, elbows, knees, and hips. Osteoarthritis frequently affects the small finger joints and thumb, as well as the knees. Rheumatoid arthritis always affects multiple joints, whereas osteoarthritis may only affect one particular joint or area of the body.

At the onset of rheumatoid arthritis, symptoms like fatigue, fever, weight loss, and loss of appetite are indicative of the disease’s development. Osteoarthritis doesn’t produce these types of additional symptoms.

One common characteristic of rheumatoid arthritis is that it produces symmetrical symptoms, meaning both sides of the body are affected similarly. Osteoarthritis doesn’t necessarily produce the same symptoms. It’s based entirely on wear and tear levels in individual joints.

Rheumatoid arthritis symptoms also include prolonged morning stiffness lasting greater than 30 minutes. Osteoarthritis patients may feel morning stiffness, but it generally subsides within the first 30 minutes.

Here is a comparison between rheumatoid arthritis and osteoarthritis symptoms:

Rheumatoid Arthritis:

  • Joint pain, stiffness, swelling affecting multiple joints
  • Symmetrical symptoms affecting both sides of the body
  • Morning stiffness lasting longer than 30 minutes
  • Additional symptoms like fatigue, fever, and malaise

Osteoarthritis Symptoms:

  • Joint pain and stiffness usually affecting hands, fingers or knees
  • Joints on one side affected worse than on the other side
  • Morning stiffness lasting fewer than 30 minutes
  • Possible spine and hip pain as well

Rheumatoid Arthritis vs. Osteoarthritis: Diagnosis

Though both diseases are forms of arthritis, they have two separate clinical diagnoses. Sometimes it can be difficult to reach a proper diagnosis because the two have such similar physical symptoms.

Rheumatoid arthritis is diagnosed by performing a physical examination of symptoms as well as taking into account family medical history. Doctors also perform blood tests to look for the presence of antibodies that are known triggers of rheumatoid arthritis. Imaging tests are also performed to look for signs of joint damage and inflammation.

Osteoarthritis is also diagnosed with imaging tests. X-rays and MRIs show the progressive damage and deterioration happening the joints. Osteoarthritis can’t be diagnosed with a specific blood test. However, blood tests can help rule out rheumatoid arthritis or other diseases that cause joint pain and inflammation.

Rheumatoid Arthritis vs. Osteoarthritis: Prognosis

Both diseases are chronic meaning they are long-term. Neither diseases have any known cures. Osteoarthritis is degenerative, meaning it will continue to worsen with time. With appropriate treatment, osteoarthritis can generally have a positive prognosis.

Rheumatoid arthritis is much more unpredictable. Numerous complications can arise as a result of the autoimmune disorder. In some cases, other conditions like respiratory and cardiovascular diseases can develop. Rheumatoid arthritis patients are also at risk of diseases like lymphoma and lupus. Because rheumatoid arthritis can progress differently in each patient, there is no general prognosis.

Rheumatoid Arthritis vs. Osteoarthritis: Treatment

Neither form of arthritis has any known cure. The objective of treatment for both types of arthritis is to reduce pain, manage symptoms, and prevent further destruction to the joints. Nonsteroidal anti-inflammatory medications like ibuprofen are used to treat both types of arthritis symptoms by reducing swelling and pain.

Because rheumatoid arthritis is an autoimmune disorder, specific drugs are prescribed to stop the immune system attacks and prevent further damage.

Physical and occupational therapy are both used to help patients improve mobility and adjust their daily routines. Exercise, weight management, and overall healthy living habits are essential in treating and manage both diseases.

Source: RheumatoidArthritis.org

Read also at National Institutes of Health:

Osteoporosis and Arthritis: Two Common but Different Conditions . . . . .

Studies Link Healthy Brain Aging to Omega-3 and Omega-6 Fatty Acids in the Blood

Two new studies link patterns of polyunsaturated fatty acids in the blood to the integrity of brain structures and cognitive abilities that are known to decline early in aging.

The studies add to the evidence that dietary intake of omega-3 and omega-6 fatty acids can promote healthy aging, the researchers said. Further research is needed to test this hypothesis, they said.

The brain is a collection of interconnected parts, each of which ages at its own pace. Some brain structures, and the abilities they promote, start to deteriorate before others, said University of Illinois M.D./Ph.D student Marta Zamroziewicz, who led the new research with psychology professor Aron Barbey.

“We studied a primary network of the brain — the frontoparietal network – that plays an important role in fluid intelligence and also declines early, even in healthy aging,” Zamroziewicz said. Fluid intelligence describes the ability to solve problems one has never encountered before.

“In a separate study, we examined the white matter structure of the fornix, a group of nerve fibers at the center of the brain that is important for memory,” she said.

Previous research has shown that the fornix is one of the first brain regions to be compromised in Alzheimer’s disease.

In both studies, the researchers looked for patterns of polyunsaturated fatty acids in the blood of adults ages 65 to 75. They analyzed the relationship between these nutrient patterns and subjects’ brain structure and performance on cognitive tests. This research differs from other such studies, which tend to focus on only one or two polyunsaturated fatty acids, Zamroziewicz said.

“Most of the research that looks at these fats in health and healthy aging focuses on the omega-3 fatty acids DHA and EPA, but those come from fish and fish oil, and most people in the Western Hemisphere don’t eat enough of those to really see the benefits,” she said. Other fatty acids, like alpha-linolenic acid and stearidonic acid, are precursors of EPA and DHA in the body. Those fats can be derived from land-based foods such as nuts, seeds and oils.

“A central goal of research in nutritional cognitive neuroscience is to understand how these nutrients affect brain health,” Zamroziewicz said. “Some of these nutrients are thought to be more beneficial than others.”

In a study reported in the journal Nutritional Neuroscience, the researchers looked for relationships between several omega-3 fatty acids in the blood, the relative size of structures in the frontal and parietal cortices of the brain, and performance on tests of fluid intelligence in healthy elderly adults.

The team found correlations between blood levels of three omega-3 fatty acids — ALA, stearidonic acid and ecosatrienoic acid — and fluid intelligence in these adults. Further analyses revealed that the size of the left frontoparietal cortex played a mediating role in this relationship. People with higher blood levels of these three nutrients tended to have larger left frontoparietal cortices, and the size of the frontoparietal cortex predicted the subjects’ performance on tests of fluid intelligence.

“A lot of research tells us that people need to be eating fish and fish oil to get neuroprotective effects from these particular fats, but this new finding suggests that even the fats that we get from nuts, seeds and oils can also make a difference in the brain,” Zamroziewicz said.

In the second study, the team found that the size of the fornix was associated with a balance of omega-3 and omega-6 fatty acids in the blood, and that a more robust fornix coincided with memory preservation in older adults. Again, the researchers saw that brain structure played a mediating role between the abundance and balance of nutrients in the blood and cognition (in this case, memory). The findings are reported in the journal Aging & Disease.

“These findings have important implications for the Western diet, which tends to be misbalanced with high amounts of omega-6 fatty acids and low amounts of omega-3 fatty acids,” Zamroziewicz said.

“These two studies highlight the importance of investigating the effects of groups of nutrients together, rather than focusing on one at a time,” Barbey said. “They suggest that different patterns of polyunsaturated fats promote specific aspects of cognition by strengthening the underlying neural circuits that are vulnerable to disease and age-related decline.”

Source: University of Illinois Urbana-Champaign

Today’s Comic

The DASH Diet May Guard Against Gout

Leslie Beck wrote . . . . . .

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks and red and processed meats, is associated with a lower risk of gout. A typical ‘Western’ diet, on the other hand, is associated with a higher risk of gout.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood which leads to uric acid crystals collecting around the joints.

The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood and may, then, protect against gout.

To investigate, a team of US and Canada based researchers examined the relationship between the DASH diet and Western dietary patterns and the risk of gout.

They analyzed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts).

During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

These associations were independent of known risk factors for gout, such as age, body mass index, high blood pressure and alcohol and coffee intake.

The authors point out that this is an observational study, so no firm conclusions can be drawn about cause and effect.

Nevertheless, they say the DASH diet may provide a preventive dietary approach for the risk of gout as it also treats high blood pressure, which affects the vast majority of gout patients.

Source: Leslie Beck

Today’s Comic

Aerobic-plus-resistance Combo Workout May Suit Obese Seniors Best

Kathleen Doheny wrote . . . . . .

Older, obese adults need to shed weight, but dieting can worsen their frailty. A new study addresses this conundrum, suggesting seniors take up both aerobic and resistance exercise while slimming down.

Engaging in aerobic and resistance exercise while losing weight enabled study participants to maintain more muscle mass and bone density compared to folks who did just one type of exercise or none at all, the researchers found.

“The best way to improve functional status and reverse frailty in older adults with obesity is by means of diet and regular exercise using a combination of resistance and aerobic exercise training,” said study leader Dr. Dennis Villareal. He’s a professor of medicine at Baylor College of Medicine in Houston.

More than one-third of people age 65 and older in the United States are obese, according to the study authors. Obesity worsens the typical age-related decline in physical functioning and causes frailty, while weight loss can lead to harmful declines in muscle mass and bone density.

The researchers wanted to see what combination of exercise, along with dieting for weight loss, might be best. They randomly assigned 160 obese and sedentary adults, age 65 or older, to one of four groups: weight loss and aerobic training; weight loss and resistance training; or weight loss and a combination of both types of exercise. The fourth group served as controls and didn’t exercise or try to lose weight.

After six months, physical performance test scores increased by 21 percent in the combination exercise group, but just 14 percent among those who only did aerobic exercise or resistance exercise, Villareal’s team said.

The researchers also found that lean body mass and bone density declined less in the combination and resistance groups than in the aerobic group.

One strength of the study is its evaluation of several regimens, said Miriam Nelson, director of the Sustainability Institute at the University of New Hampshire.

Such research is critical, as ”the majority of [older] people are either overweight or obese,” said Nelson, who wasn’t involved in the study.

While many studies of obese or overweight older adults focus only on exercise and weight loss, “this is really looking at health,” she said.

“Health in aging is really [about] functioning,” Nelson said. Maintaining muscle strength and bone density is essential to remain mobile and functional, she pointed out.

“All these multiple factors are what dictate to a large extent somebody’s ability to be independent, healthy and to live life to its fullest as they age,” Nelson added.

At the outset of the study, participants were mildly to moderately frail, according to the authors.

The researchers assessed the seniors’ physical performance, muscle mass and bone health over the 26-week study.

The overall winners, the combination group, exercised three times a week, from 75 to 90 minutes each session.

Aerobic exercises included treadmill walking, stationary cyclingand stair climbing. Resistance training involved upper-body and lower-body exerciseson weight-lifting machines. All groups also did flexibility and balance exercises.

The study was published in the New England Journal of Medicine.

Source: HealthDay

Today’s Comic

New Liquid Treatment Stops Tooth Decay Painlessly

Wency Leung wrote . . . . . . .

Dr. Katherine Roche hopes she can now avoid drilling many of her patients’ teeth.

A few weeks ago, the Edmonton dentist received her first shipment of a new, non-invasive treatment for tooth decay called silver diamine fluoride.

When applied to an affected tooth, the liquid treatment stops decay by killing cavity-causing bacteria, then remineralizes, or hardens, soft spots in the tooth, eliminating the need for drilling and filling.

So far, Roche has tried it on about a dozen patients, some as young as five. But she already believes it “really revolutionizes the care” for children, seniors and other patients who don’t tolerate dental procedures well.

“You just paint it on like a little bit of varnish … no freezing and drilling. It takes a minute to apply this material,” said Roche, owner of the Guardian Dental clinic.

Silver diamine fluoride has been used for years in Japan, Australia and Argentina. But only recently has it been approved in Canada, under the product name Advantage Arrest. Health Canada licensed Advantage Arrest in February to be used by dental professionals “to prevent, fight and protect against cavities or caries.”

Until now, Canadian dentists have treated cavities by drilling away the soft, decaying areas of a tooth and replacing them with another substance, such as a composite or amalgam filling.

Silver diamine fluoride “is the easiest, simplest way to stop dental decay that has already started,” said Benoit Soucy, the director of clinical and scientific affairs at the Canadian Dental Association.

But, he added, it’s not for everyone – especially “anybody who is concerned about the appearance of their smile.”

That’s because the chief drawback of silver diamine fluoride is that it stains the tooth a dark brown or black.

It also does not fill in the parts of the tooth that have been corroded away, though a dentist can rebuild the structure of a tooth after the material hardens. And it isn’t the best option when the decay is very advanced or when there is damage below the tooth, Roche says.

Still, Roche says silver diamine fluoride offers a better option for young children – who often can’t endure extensive dental work – than giving them a general anesthetic for traditional fillings.

Moreover, any staining that occurs in their baby teeth will not affect their adult teeth.

Plus, it is less costly than traditional fillings. At her clinic, a silver diamine fluoride treatment is billed per unit of time. She can treat an entire mouth within 15 minutes, which she estimates would not cost more than $100. By comparison, filling a cavity would cost about $200.

Aside from the time and discomfort involved, fillings also don’t do anything to address the bacteria that cause cavities. With fillings, “it’s surgery versus medicine,” Roche said.

But with silver diamine fluoride, the risk of developing new cavities throughout the mouth is reduced due to what’s called the “zombie effect,” she explained. “What happens is bacteria will take up the silver ions and they will go visit their other bacteria friends and they spread that silver ion around … and kill those bacteria as well.”

A second treatment is recommended six months after the first.

Soucy emphasizes that people should not be scared off by the idea of staining if silver diamine fluoride is deemed the best approach for them. It can be regarded as a “necessary evil” for certain individuals, for whom the treatment can prevent major dental problems in the future, he says.

Even so, he says, he doesn’t expect dentists to give up their drills any time soon.

“It will definitely not replace fillings,” he said. “This is an additional tool that helps to treat certain, very specific situations that had no good options until now.”

Source: The Globe and Mail