Comparison chart Genetic Factors Gender
Age of onset Severity Speed of onset Disease Process Cause
Osteoarthritis Family HX of OA women "ommon in #oth men and women$ !efore %& more men than women, after %& more women than men Over (&
Less severe +low, over years ormal wear and tear chronic chronic degenerative. wear and tear associated with aging or in/ury, also caused #y in/uries to the /oints, o#esity, o#esity, heredity, heredity, overuse of the /oints from sports +ystemic symptoms are not present$ Locali2ed /oint pain 3nee 3nee and hips. #ut O swelling 4ain severity is important mechanical, in5ammatory, nocturnal, nocturnal, sudden.
Presence of symptom s aecting the whole ody !systemic " #oint 9oints painful painful #ut without without symptom swelling1 a'ects /oints s asymmetrically1 a'ects #igger /oints such as hips : knees$ Locali2ed with varia#le, progressive course Pattern Asymmetrical : may of $oints spread to the other side$ that are +ymptoms #egin aected gradually and are often limited to one set of /oints, usually usually the 0nger /oints closest closest to the 0ngernails or the thum#s, large weight-#earing /oints pain with move moveme ment nt incr increa ease ses s pain pain
Rheumatoid Arthritis RA and Leukocyte antigenfemale reproductive hormones, pstein-!arr virus A'ects more women than men
)%-*% years old
Gout Family history of gout
more common in men and in women after menopause
+evere Rapid, within a year
usually over )% years of age in men and after menopause in females +evere +udden onset
chronic Autoimmune
meta#olic di disease
"lassi0ed as an autoimmune disease, o real known cause$ "onnection #etween environmental and genetic factors1 female reproductive hormones 6ull pain and in5ammation Fre7uent fatigue afternoon., sti'ness, ulnar deviation, muscle atrophy, swelling of the knuckles , synovial thickness complications8 complications8 /oint fail, depression depression,, osteoporosis, infections surgical complications 9oints are are painful, swollen, swollen, and sti'1 a'ects /oints symmetrically1 a'ects smaller /oints such as hands : ankles$ +ystemic with e;acer#ations e;acer#ations and remissions +ymmetrical - often a'ects small and large /oints on #oth sides of the #ody, such as #oth hands, #oth wrists or el#ows, or the #alls of #oth feet
move moveme ment nt decr decrea ease ses s pain pain
deposition of uric acid around /oints
"hills and a mild fever along with a general feeling of malaise may also accompany the severe pain and in5ammation
/oints are are hot, red red swollen and e;tremely painful
Asymmetrical - 9oint of the #ig toe most commonly a'ected$ other /oints a'ected are of ankle, heel, knee, wrist, 0ngers, el#ow etc$
movemen t Associate d symptom s
%usions
&odules
no systemic symptoms. fatigue, muscle weakness, fever, organ involvement1 !ony enlargement, deformity, insta#ility, restricted movement, /oint locked, sleep distur#ance, depression, comor#id conditions #ursitis, 0#romyalgia, gout. local in5ammation@e'usion sometimes Her#erden>s : !ouchard>s nodes
Assessm ent
One or several /oints1 enlarged, cool, and hard on palpation
Radiologi c 'ndings
Loss of /oint space and articular cartilage, routine wear and tear osteophytes, sclerosis, cysts, loose #odies, alignment
Diagnosis
X-ray, pain assessmentperarticular and articular source of pain, presence of deformity, evidence of muscle wasting, local in5ammation$ asymmetrical /oints Rheumatoid Factors RF. negative, transient elevation in +R related to synovitis
(a 'ndings
Fre7uent feelings of =#eing ?ophi may form$ ?hese sick inside,= with fevers, are large masses of uric weight loss, or involvement acid crystals, which gets of other organ systems$ collect in the /oints and carpal tunnel ;tra-articular damage it$ ?hey also manifestations8 nodules, gets collected in the vasculitis, pulmonary, #one and cartilage, such cardiac, skin vasculitis., eye as in the ears$ +/orgen>s syndrome, scleritis "ommon
"ommon
4resent, especially on ?ophi form in e;tensor surfaces$ +wan the /oints, cartilage, #on neck deformity$ !iopsy es, and other places important to eliminate gouty throughout the #ody$ tophi +ometimes, tophi #reak through the skin and appear as white or yellowish-white, chalky nodules$ 9oints are swollen, red, Barmth, pain, swelling, warm, tender, and painful1 and e;treme tenderness several /oints involved1 ;tra in a /oint, usually a #ig articular8 Rheumatoid toe /oint$ 4ain often nodules, +/ogrens starts during the night$ syndrome, Felty syndrome !ony erosions, soft tissue A#sence of periarticular swelling, angular deformities osteopenia, eccentric erosions$ ?ypical appearance8 presence of well-de0ned CpunchedoutD erosions with sclerotic margins in a marginal and /u;taarticular distri#ution, with overhanging edges$ E- Anemia ferritin, ion$ ion X-ray, serum uric acid #inding capacity. levels, urinary uric acid, - #one including AL4. )synovial 5uid analysis8 Gn5ammatory markers " eedles of urate reactive protein and +R. crystals seen on polari2ing microscopy$ RF positive, increased +R : "R4, antinuclear anti#ody, arthrocentesis
RF negative, elevated serum uric acid, check level urinary uric acid
)reatmen t
+AG6s short term use. Acetaminophen, Analgesics, e;ercise
+AG6s, +teroids 4rednisone., 6
+AG6s, "olchicine, steroids, rocosuric