Table 1 Comparison between rheumatoid arthritis and osteoarthritis disease characteristics
Characteristics | Rheumatoid arthritis | Osteoarthritis |
|---|---|---|
Major risk factors | Genetics (MHC HLA alleles) and environment (periodontitis, smoking, and gut microbes) | Aging, obesity, female gender, joint biomechanics, injury, and genetics (GDF5) |
Age at onset | May occur at any age | Around 65 years + |
Symptoms | • Painful, swollen, and stiff joints • Multiple joints usually in hands, wrists, elbows, and feet, with symmetrical presentation (affects both sides of the body) • Systemic reaction (fatigue and malaise) | • Tender, aching joints with some swelling/pain • Usually present on one side of the body in large weight-bearing joints such as the knee, hips, and spine • No systemic symptoms |
Disease onset | Fast (weeks—months) | Slow (years) |
Mechanism | Systemic autoimmune reaction (production of autoantibodies e.g., RF and ACPAs) | Local tissue degeneration due to aging, biomechanical, metabolic, and inflammatory changes |
Pathological features | • Major synovial reaction (inflammation, hyperplasia, and pannus formation) • Destruction of cartilage by pannus invasion • Bone erosion (osteoclast activation) | • Cartilage damage (“wear and tear”) • Bone sclerosis • Bone marrow lesions (early stage) • Osteophytes • Synovial inflammation |
Treatment | Glucocorticoids, NSAIDs and DMARDs (synthetic e.g., methotrexate and biological e.g., anti-TNF-α) | Pain management (NSAIDs, intra-articular glucocorticoid injections), lifestyle modification (exercise and diet), and joint replacement surgery |
