Question

osteoarthritis and rheumatoid arthritis pathophysiology, diagnosis, clinical manifestation, treatment, health promotion/teaching

Answer 1

Osteoarthritis is a degenerative joint disease ,occurs when smooth cartilage of joint surface wears out . It affects isolated joints

Rheumatoid arthritis is an autoimmune disease means immune system attacks it's own body considering it as foreign body . It is bilateral , symmetrical ,affects small joints first , then large ones. It's typical feature is morning stiffness of small joints of hands .

Pathophysiology of osteoarthritis :-Pathophysiology of Rheumatoid arthritis :-

Clinical manifestation of osteoarthritis are :-

- pain

- morning stiffness less than 30 mins

- palpable bony joint enlargement

- reduced range of motion

- crepitus

- joint malalignment

Clinical manifestation of Rheumatoid arthritis are :-

- pain duration more than 6 weeks

- morning stiffness more than 30 mins

- fever

- weight loss

- anemia

- sensory changes and lymph node enlargement

- fatigue

- anorexia

- synovitis

- joint involvement is symmetrical and bilateral

- extra articular manifestation like SLE , Raynaud's phenomenon,sjrogen syndrome ,scleritis , splenomegaly , pericarditis etc

Diagnosis is made by the following methods for osteoarthritis are :-

- physical examination

- blood test

- joint fluid analysis

- X- ray

- MRI

Diagnosis is made by the following method for rheumatoid arthritis are :-

- physical examination

- RA factor

- blood tests

- ESR

- C-reactive protein analysis

- antinuclear antibody test

- Arthrocentesis

- X-ray

- MRI

Treatment for osteoarthritis are :-

- NSAIDS

- Acetaminophen

- duloxetine

- physiotherapy

- yoga

- exercise

Surgical intervention are :-

- corticosteroid injection

- realignment

- lubrication injection

- joint replacement

Treatment of Rheumatoid arthritis are :-

- NSAIDS

- Antimalarials

- penicillamine

- sulfasalazine

- methotrexate

- corticosteriod therapy

- Immunosuppressive therapy such as cyclophosphamide

- low dose antidepressants medication like amitriptyline

- reconstructive surgery

Health teaching for both the diagnosis are :-

- teach patient to take the medicines as prescribed .

- teach patient to do range of motion exercises

- encourage them to be independent as much as possible

- avoid weight bearing and strenous activities

- intake of protein rich high calorie diet

- teach patient about basic necessary adaptations in lifestyle

- teach patient about skin care who are bed ridden partially or completely and how to take care of bed sores .

- encourage patient and family to verbalise their concerns

- teach patient to have monitor of blood sugar due to risk of hyperglycemia related to corticosteroids.

- teach patient complications ,and when to reach the physician