Arthritis and Its Pathophysiology

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Introduction

There exist many types of arthritis (joint pain) that develop in people of all ages, ethnicities, and environments. To treat them, one has to understand the differences in their pathophysiology and presentation. For example, osteoarthritis and rheumatoid arthritis may have similar symptoms, but their causes and prevalence vary. Thus, people’s inherent characteristics and habits also produce different effects on these conditions – age and gender change the pathophysiology and diagnosis of both osteoarthritis and rheumatoid arthritis.

Pathophysiology

Osteoarthritis can be considered one of the most wide-spread forms of arthritis (Mobasheri & Batt, 2016). The prevalence of this joint disease in relation to other types is substantial, as it is much more common than such conditions as rheumatoid arthritis. Osteoarthritis progresses with time, affecting a person’s joint tissues such as cartilage (Mobasheri & Batt, 2016). In a person without osteoarthritis, cartilage maintains its volume, having a balanced movement of water under osmotic and hydrostatic pressure. As a contrast, in joints affected by osteoarthritis, the matrix of the cartilage becomes unbalanced, losing collagen and proteoglycans – components which are responsible for the water contents of the joint (Mobasheri & Batt, 2016). The body attempts to repair the cartilage and remodels it to replace the missing elements, but fails to heal the joint in time. Thus, the cartilage may crack or erode, exposing the bone and decreasing joint space.

The primary distinction of rheumatoid arthritis is that it is an autoimmune disorder. In this case, the body starts activating “B cells, T cells, and innate immune effectors” to attack its own joint synovium (Hammer & McPhee, 2014, p. 689). Healthy synovium lubricates cartilage and provides it with nutrients. It has a very thin layer of cells and an interstitium underneath (Hammer & McPhee, 2014). When rheumatoid arthritis starts affecting the body, the synovium becomes much thicker than the healthy one, and the interstitium becomes inflamed with active cells. Cartilage and bone which are located near such highly contagious areas get damaged in the process of active cells spreading and attacking other regions. Thus, the person experiences swelling and pain in his/her joints due to inflammation. While both disorders affect joints, their progression and causes are different.

Patient Factors

Such factors as one’s age and gender may affect the progression of these disorders. Osteoarthritis, for instance, is often related to aging – it is one of the primary causes of disability in older people (Sun, Beier, & Pest, 2017). People above 60 years old can develop this disorder, although some other aspects may affect the rates as well. As a contrast, rheumatoid arthritis is not as strongly dependent on one’s age. Numerous cases of infant and adolescent patients developing this condition exist (Hammer & McPhee, 2014; Singh et al., 2016). People of all ages can have rheumatoid arthritis of varying severity. It is clear that age affects the way these disorders can be treated – children and older people react more strongly to drugs than younger adults. Therefore, their doses and types of medication need to be adjusted accordingly.

Gender is another factor which creates distinct groups of patients with these disorders. In both cases, females are affected by arthritis more often than males. However, some scholars suggest that the rate of women with the rheumatoid type is much higher than that of men with the same condition, having a prevalence of three to one (Hammer & McPhee, 2014). Nonetheless, Singh et al. (2016) do not indicate that gender affects treatment options.

Conclusion

Osteoarthritis and rheumatoid arthritis are disorders that target similar areas of one’s body but progress in different ways. Although some symptoms – joint pain and swelling – are the same for both conditions, their pathophysiology shows that they are caused by two separate reasons. Osteoarthritis occurs in older people, while rheumatoid arthritis can affect a person of any age. Nevertheless, both conditions are more prevalent in women.

References

Hammer, G. G., & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine (7th ed.) New York, NY: McGraw-Hill Education.

Mobasheri, A., & Batt, M. (2016). An update on the pathophysiology of osteoarthritis. Annals of Physical and Rehabilitation Medicine, 59(5-6), 333-339.

Singh, J. A., Saag, K. G., Bridges, S. L., Jr., Akl, E. A., Bannuru, R. R., Sullivan, M. C.,… McAlindon, T. (2016). 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis & Rheumatology, 68(1), 1-26.

Sun, M. M. G., Beier, F., & Pest, M. A. (2017). Recent developments in emerging therapeutic targets of osteoarthritis. Current Opinion in Rheumatology, 29(1), 96-102.

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