Respond on two different days who selected different factors than you, in one or more of the following ways:
Offer alternative diagnoses and prescription of treatment options for osteoarthritis and rheumatoid arthritis.
Share an insight from having read your colleague’s posting, synthesizing the information to provide new perspectives.
Main Post
Rheumatoid arthritis and osteoarthritis both involve inflammation and affect the joints. Rheumatoid arthritis is a chronic systemic inflammatory disease characterized by the persistent symmetric inflammation of multiple peripheral joints (Hammer & McPhee, 2019). Osteoarthritis is characterized by local areas of loss and damage of articular cartilage, inflammation, new bone formation of joint margins, subchondral bone changes, variable degrees of mild synovitis, and thickening of the joint capsule (Huether & McCance, 2017).
Pathophysiology
Osteoarthritis is most commonly from wear and tear of the cartilage around the joint; this can be enhanced form sports or overuse at a particular occupation. Pro-inflammatory factors are released, and catabolic activation begins resulting in a net degradation of cartilage extracellular matrix (Esa et al., 2019). The cartilage becomes and may be absent over some areas, leaving the bone unprotected (Huether & McCance, 2017). Rheumatoid arthritis pathophysiology involves the destruction of the synovial linings that protect the joints; these linings provide nutrients and lubrication for the articular cartilage. Hammer and McPhee (2019) explain that enhanced pro-inflammatory cytokine production is a dominant feature of rheumatoid arthritis.
Gender and Ethnicity’s Impact
Rheumatoid arthritis is most typically a persistent, progressive disease presenting in women in the middle years of life (Hammer & McPhee, 2019). Studies have shown that hormones play a role in the development of rheumatoid arthritis, specifically when women are undergoing hormonal changes at childbirth and menopause. All these phenomena have in common an acute decline in ovarian function and/or in oestrogen bioavailability (Alpízar-Rodríguez, Pluchino, Canny, Gabay, & Finckh, 2016). The peak incidence in females coincides with menopause when the ovarian production of sex hormones drops markedly (Karsdal, Bay-Jensen, Henriksen, & Christiansen, 2012). No evidence supports that ethnicity is a factor in rheumatoid arthritis. Several studies performed, but due to their limitations and sample sizes, they could not be validated.
Although osteoarthritis incidence rates are quite similar in men and women, after age 50, women typically are more severely affected (Huether & McCance, 2017). Following the same pattern as rheumatoid arthritis with menopausal and post-menopausal women. Several experimental studies have shown that estrogens are implicated in the regulation of cartilage metabolism (Mahajan & Patni, 2018). Again for osteoarthritis, no research clearly recognized that ethnicity enhanced the disease process.
Conclusion
Both osteoarthritis and rheumatoid arthritis are the two most common forms of arthritis that affect millions of people. The symptoms can be very similar, and a thorough examination should be done to distinguish between the two. Osteoarthritis usually affects one joint, while rheumatoid arthritis affects several joints at once.
References
Alpízar-Rodríguez, D., Pluchino, N., Canny, G., Gabay, C., & Finckh, A. (2016). The role of female hormonal factors in the development of rheumatoid arthritis. Rheumatology. https://doi-org.ezp.waldenulibrary.org/10.1093/rheumatology/kew318
Esa, A., Connolly, K., Williams, R., & Archer, C. (2019). Extracellular Vesicles in the Synovial Joint: Is there a Role in the Pathophysiology of Osteoarthritis? Malaysian Orthopaedic Journal, 13(1), 1-7. https://doi-org.ezp.waldenulibrary.org/10.5704/MOJ.1903.012
Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Karsdal, M. A., Bay-Jensen, A. C., Henriksen, K., & Christiansen, C. (2012). The pathogenesis of osteoarthritis involves bone, cartilage and synovial inflammation: may estrogen be a magic bullet? Menopause International, 18(4), 139–146. https://doi-org.ezp.waldenulibrary.org/10.1258/mi.2012.012025
-org.ezp.waldenulibrary.org/10.4103/jmh.JMH_157_18doi(4), 171. of Mid-life Health,, R. (2018). Menopause and Osteoarthritis: Any Association? Patni, A., & Mahajan
Week 2 Discussion 2 Post.doc (59 KB)
Expert Solution Preview
Introduction: Osteoarthritis and rheumatoid arthritis are both types of arthritis that involve inflammation and affect the joints. While they share some similarities, they also have distinct differences in terms of their pathophysiology, gender and ethnicity impact, and clinical manifestations. In this response, I will provide alternative diagnoses and prescription of treatment options for osteoarthritis and rheumatoid arthritis, as well as a new perspective based on the information provided in the main post.
Alternative Diagnoses and Treatment Options for Osteoarthritis and Rheumatoid Arthritis:
1. Alternative Diagnoses for Osteoarthritis:
– Gout: Gout is a form of arthritis caused by the buildup of uric acid crystals in the joints. It typically affects one joint at a time, often the big toe, and is associated with severe pain, swelling, and redness.
– Psoriatic Arthritis: Psoriatic arthritis is a type of arthritis that affects some individuals with psoriasis. It can cause joint inflammation, pain, and stiffness, similar to osteoarthritis.
Prescription of Treatment Options for Osteoarthritis:
– Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen or naproxen, can help relieve pain and reduce inflammation in osteoarthritis.
– Physical therapy: Physical therapy can improve joint mobility, strengthen muscles around the affected joint, and relieve pain in osteoarthritis.
– Joint injections: Corticosteroid injections into the affected joint can provide temporary pain relief in osteoarthritis.
2. Alternative Diagnoses for Rheumatoid Arthritis:
– Systemic Lupus Erythematosus (SLE): SLE is an autoimmune disease that can affect various organs, including the joints. It can cause symmetric joint inflammation and pain similar to rheumatoid arthritis.
– Sjögren’s syndrome: Sjögren’s syndrome is an autoimmune condition characterized by dry eyes and mouth. It can also cause joint pain and inflammation, resembling rheumatoid arthritis.
Prescription of Treatment Options for Rheumatoid Arthritis:
– Disease-modifying antirheumatic drugs (DMARDs): DMARDs, such as methotrexate or sulfasalazine, are commonly used to slow down the progression of rheumatoid arthritis and reduce joint damage.
– Biologic agents: Biologic agents, such as tumor necrosis factor (TNF) inhibitors or interleukin-6 (IL-6) inhibitors, can target specific inflammatory pathways in rheumatoid arthritis and provide better disease control.
– Physical and occupational therapy: Physical and occupational therapy can help improve joint function, relieve pain, and maintain independence in individuals with rheumatoid arthritis.
Insight from Colleague’s Post:
After reading my colleague’s post, I gained a new perspective on the impact of gender and ethnicity in rheumatoid arthritis and osteoarthritis. My colleague highlighted the role of hormonal changes in women, specifically during menopause and childbirth, in the development of rheumatoid arthritis. This insight underscores the importance of considering hormone replacement therapy and other hormonal interventions as potential treatment options for women with rheumatoid arthritis. Furthermore, my colleague discussed the association between estrogen and cartilage metabolism, suggesting that targeted estrogen therapies could potentially modulate the disease processes in both rheumatoid arthritis and osteoarthritis. This information provides a new perspective on the potential influence of estrogen in the pathophysiology and treatment of these arthritic conditions.
