Comparison chart OA vs RA vs GOUT PDF

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Download Comparison chart OA vs RA vs GOUT PDF

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Comparison chart Genetic Factors Gender

Age of onset

Severity Speed of onset Disease Process Cause

Presence of symptoms affecting the whole body (systemic)

Joint symptoms

Pattern of joints that are affected

pain with movement Associated symptoms

Osteoarthritis Family HX of OA women Common in both men and women. Before 50 more men than women, after 50 more women than men Over 60

Rheumatoid Arthritis RA and Leukocyte antigen- female reproductive hormones, EpsteinBarr virus Affects more women than men

more common in men and in women after menopause

Less severe Slow, over years

Severe Rapid, within a year

usually over 35 years of age in men and after menopause in females Severe Sudden onset

Normal wear and tear (chronic degenerative) wear and tear associated with aging or injury, also caused by injuries to the joints, obesity, heredity, overuse of the joints from sports Systemic symptoms are not present. Localized joint pain (Knee and hips) but NO swelling Pain severity is important (mechanical, inflammatory, nocturnal, sudden)

chronic Autoimmune

metabolic disease

Classified as an autoimmune disease, No real known cause. Connection between environmental and genetic factors; female reproductive hormones Dull pain and inflammation Frequent fatigue (afternoon), stiffness, ulnar deviation, muscle atrophy, swelling of the knuckles , synovial thickness complications: joint fail, depression, osteoporosis, infections surgical complications Joints are painful, swollen, and stiff; affects joints symmetrically; affects smaller joints such as hands & ankles. Systemic with exacerbations and remissions

deposition of uric acid around joints

Symmetrical - often affects small and large joints on both sides of the body, such as both hands, both wrists or elbows, or the balls of both feet

Asymmetrical - Joint of the big toe most commonly affected. other joints affected are of ankle, heel, knee, wrist, fingers, elbow etc.

movement decreases pain

Movement increase pain

Frequent feelings of "being sick inside," with fevers, weight loss, or involvement of other organ systems. carpal tunnel Extraarticular manifestations: nodules,

Tophi may form. These are large masses of uric acid crystals, which gets collect in the joints and damage it. They also gets collected in the bone and cartilage, such as in the

Joints painful but without swelling; affects joints asymmetrically; affects bigger joints such as hips & knees. Localized with variable, progressive course Asymmetrical & may spread to the other side. Symptoms begin gradually and are often limited to one set of joints, usually the finger joints closest to the fingernails or the thumbs, large weight-bearing joints movement increases pain (no systemic symptoms) fatigue, muscle weakness, fever, organ involvement; Bony enlargement, deformity, instability, restricted movement, joint locked, sleep

35-45 years old

Gout Family history of gout

Chills and a mild fever along with a general feeling of malaise may also accompany the severe pain and inflammation

joints are hot, red swollen and extremely painful

disturbance, depression, comorbid conditions (bursitis, fibromyalgia, gout) local inflammation/effusion sometimes Herberden's & Bouchard's nodes

vasculitis, pulmonary, cardiac, skin (vasculitis), eye (Sjorgen's syndrome, scleritis Common

Assessment

One or several joints; enlarged, cool, and hard on palpation

Radiologic findings

Loss of joint space and articular cartilage, routine wear and tear osteophytes, sclerosis, cysts, loose bodies, alignment

Joints are swollen, red, warm, tender, and painful; several joints involved; Extra articular: Rheumatoid nodules, Sjogren’s syndrome, Felty syndrome Bony erosions, soft tissue swelling, angular deformities

Diagnosis

X-ray, pain assessmentperarticular and articular source of pain, presence of deformity, evidence of muscle wasting, local inflammation. asymmetrical joints Rheumatoid Factors (RF) negative, transient elevation in ESR related to synovitis NSAIDs (short term use) Acetaminophen, Analgesics, exercise

Effusions Nodules

Lab findings

Treatment

Present, especially on extensor surfaces. Swan neck deformity. Biopsy important to eliminate gouty tophi

1- Anemia (ferritin, ion. ion binding capacity) 2- bone (including ALP) 3Inflammatory markers (C reactive protein and ESR) RF positive, increased ESR & CRP, antinuclear antibody, arthrocentesis NSAIDs, Steroids (Prednisone), DMARDs (Methotrexate), Antimalarial (Plaquenil), Corticosteroids

ears.

Common Tophi form in the joints, cartilage, bones, and other places throughout the body. Sometimes, tophi break through the skin and appear as white or yellowishwhite, chalky nodules. Warmth, pain, swelling, and extreme tenderness in a joint, usually a big toe joint. Pain often starts during the night. Absence of periarticular osteopenia, eccentric erosions. Typical appearance: presence of well-defined “punched-out” erosions with sclerotic margins in a marginal and juxta-articular distribution, with overhanging edges. X-ray, serum uric acid levels, urinary uric acid, synovial fluid analysis: Needles of urate crystals seen on polarizing microscopy. RF negative, elevated serum uric acid, check level urinary uric acid NSAIDs, Colchicine, steroids, Urocosuric...