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Osteoarthritis
Arthritis is inflammation of
joints..
•Symptoms of arthritis;
joint pain.
Stiffness (
(worsen with age).

Types of arthritis are;
osteoarthritis.
rheumatoid arthritis.
Continued..

Definition
Explanation
Types
Symptoms
Causes
 Diagnose
Tests
Stages
Treatment and drugs
Contents Of
Osteoarthritis.

Surgery
Prevalence of OA
Physical Therapy
Risk Factors
Preventions
Difference between Osteoarthritis &
Rheumatoid Arthritis
Contents

 Degeneration of joint cartilage and the
underlying bone.
 Often called wear-and-tear arthritis.
 Occurs when the protective cartilage on
the ends of our bones wears down over
time.
 It is most common form of arthritis.
Definition of
Osteoarthritis.

Cartilage;
 Covers the ends of bones, which allows them to glide
over each other.
 It also helps in absorbing the shock of movement.
 Top layer of cartilage break down and wears away
consequently and the bones under the cartilage rub
together. That causes; pain, swelling, and loss of
motion of the joint.
 Over time, the joint may lose its normal shape
Explanation.

Osteoarthritis in knee
joint

 Bone spur extra bone growth that is not needed.
• Sometimes, bits of bone or cartilage can
break off and float inside the joint space, which causes
more pain and damage.
• Osteoarthritis gradually worsens with time, and no
cure exists.
Continue…..

 Primary Osteoarthritis.
 Secondary Osteoarthritis.
Types of Osteoarthritis.

 “wear and tear” osteoarthritis, more
commonly diagnosed.
 Spontaneous.
 No specific causes.
 Tend to develop around age 55 or 60.
 Associate with aging.
 Include joint pain, stiffness, and limitation of
movement.
Primary Osteoarthritis.

 Specific cause such as
 Injury.
 An effect of obesity.
 Genetics.
 Inactivity
 other diseases.
 Tends to strike at an earlier age, around 45
or 50.
Secondary
Osteoarthritis.

 Symptoms often develop slowly and worsen
over time.
 Signs and symptoms;
 Pain
 Tenderness
 Stiffness
 Loss of flexibility
 Grating sensation
 Bone spurs
Symptoms.

 Pain;
Joint may hurt during or after movement
 Loss of flexibility;
patient may not be able to move their joint
through its full range of motion
 Stiffness;
Joint stiffness may be most noticeable when you
wake up in the morning or after a period of
inactivity.
Symptom’s
Explanation.

Bone spurs;
These extra bits of bone, which feel like hard
lumps, may form around the affected joint.
Grating sensation;
Patient may hear or feel a grating sensation when
he use the joint.
 Tenderness;
Joint may feel tender when you apply light
pressure to it.
Continue…..

 OA occur when cartilage that cushions the end of
bones in the joint detoriates over time.
 smooth surface of cartilage become rough ,causing
irritation.
 Eventully,if the cartilage wear down competly,patient
may be left with bone rubbing on bone causing ends
of bone to become damage and joint become painful
 causes of OA are not clear in some cases researches
suspect that it’s combination of factors.
Causes.

 Factors that increase risk include;
 Older age
 Sex
 Bone deformities
 Joint injuries
 Obesity
 Certain Occupations
 Other diseases
Risk Factors

Older age.
The risk of OA increases with age.
Sex.
 Women are more likely to develop osteoarthritis,
though it isn't clear why.
Bonedeformities.
Some people are born with malformed joints or
defective cartilage, which can increase the risk of
OA.
Explanation of RF..

Joint injuries.
Injuries, such as those that occur when playing
sports or from an accident, may increase the risk of
osteoarthritis.
Obesity.
Carrying more body weight puts added stress on
your weight-bearing joints, such as your knees.
Continue..

 Certain occupations.
If your job includes tasks that place repetitive stress
on a particular joint, that joint may eventually develop
osteoarthritis.
 Other diseases.
Having diabetes, underactive thyroid, gout or Paget's
disease of bone can increase risk of developing
osteoarthritis.
Continue….

 OA is higher in women than men
 In women it
increases
dramatically around
the
time of
menopause.
Prevalence of
Osteoarthritis

 Osteoarthritis is a degenerative disease
that worsens over time. Joint pain and
stiffness may become severe enough to
make daily tasks difficult. Some people are
no longer able to work. When joint pain is
this severe, doctors may suggest joint
replacement surgery.
Complications

X-rays. Cartilage doesn't show up on X-ray
images, but the loss of cartilage is revealed by a
narrowing of the space between the bones in your
joint. An X-ray may also show bone spurs around a
joint. Many people have X-ray evidence of
osteoarthritis before they experience any
symptoms.
 Lab tests:Analyzing blood or joint fluid can
help pinpoint the diagnosis.
Test

Imaging tests:Pictures of the affected joint
can be obtained during imaging tests.
 Blood tests. Blood tests may help rule out
other causes of joint pain, such as rheumatoid
arthritis.
 Magnetic resonance imaging
(MRI). MRI uses radio waves and a strong
magnetic field to produce detailed images of bone
and soft tissues, including cartilage.
Continue..

 Joint fluid analysis. Doctor may use a
needle to draw fluid out of the affected joint.
Examining and testing the fluid from joint can
determine if there's inflammation and if pain is
caused by gout or an infection
 Arthroscopy: Arthroscopy to see inside the
joint in order to determine the case of pain.
During this small pain incision is made and small
camera is inserted to see inside the joint.
Continue.

There are 4 stages of OA
Acute Osteoarthritis.
Sub acute Osteoarthritis.
Chronic Osteoarthritis.
Degenerative Osteoarthritis.
Stages..

 Word acute in medical jargon means short-term
and/or severe.
 One might have acute pain (severe) for a short period
of time.
 When it comes to osteoarthritis, the acute stage is
characterized by occasional joint pain. Short periods
of time where joints—knees, hips, elbows, hands,
fingers—are stiff and painful to move.
 People in the acute state of osteoarthritis don’t
think of themselves as having arthritis.
 Ignore minor aches and pains.
 But this is a big mistake.
Acute OA

 Osteoarthritis is a progressive disease. Without
taking some action to arrest it in the acute stage
 Some people think the weather may play a role,
and that’s partly true.
 Cold weather does cause stiffness and loss of
flexibility in people with acute osteoarthritis. It
can take a while for joints to warm up and allow
flexibility to return.
 Treatment; one of the very best natural
treatments is Devil’s Claw extract

 People who are in the sub acute stage of
osteoarthritis are very much aware they have a
problem with their joints.
 This stage is characterized by localized joint pain.
 People may feel extreme pain and stiffness in
their fingers and hands, but their other joints
function properly and painlessly.
Sub acute OA

 The thing to remember about subacute
osteoarthritis is that “it’s not too late”.
 At this stage, localized pain and stiffness can not
only be relieved, but it can also be reversed. Like
acute osteoarthritis
Treatment. Devil’s Claw extract, glucosamine,
boswellia, and curcumin can be useful in this stage.

 If osteoarthritis has progressed to the chronic
stage, you are probably in quite a bit of pain.
 Movement in the chronic stage can be severely
limited, and patient take prescription
drugs (nonsteriodal anti-inflammatory drugs)
designed to relieve the symptoms, but do nothing
to address the cause of the disease.
 These drugs often have unpleasant side effects.
Chorionic OA

 In chronic osteoarthritis, there is still hope.
Treatment; Nature’s pharmacy contains some
amazing treatments that can bring relief to those
who are in the chronic stage.
 Again, Devil’s Claw extract,glucosamine,
chondroitin, betaine, and ginger extract.

 Degenerative stage of osteoarthritis is truly
unfortunate.
 Characterized by a complete loss of cartilage
surrounding the joint and the terrible pain of
bone rubbing on bone.
 People in the DS are often immobile, and
wheelchair bound. They are also prescribed
powerful narcotic pain killers to relieve the
condition
Degenerative OA

 There's no known cure for osteoarthritis,
but treatments can help to reduce pain and
maintain joint movement
Medications.
Acetaminophen.
No steroidal anti-inflammatory drugs .
Narcotics.
Treatment & Drugs.

A combination approach to treatment
often works best. Doctor may suggest:
Physical therapy.A physical therapist can
work with patient to create an individualized
exercise regimen that will strengthen the muscles
around joint, increase the range of motion in joint
and reduce pain.
Physical Therapy

Occupational therapy.An occupational
therapist can help you discover ways to do
everyday tasks or do your job without putting
extra stress on your already painful joint. For
instance, a toothbrush with a large grip could
make brushing your teeth easier if you have finger
osteoarthritis. A bench in your shower could help
relieve the pain of standing if you have knee
osteoarthritis.

Braces or shoe inserts. Consider trying
splints, braces, shoe inserts or other medical
devices that can help reduce pain. These devices
can immobilize or support joint to help you keep
pressure off it.
 A chronic pain class.
 These classes teach skills that help to manage
your osteoarthritis pain. And you'll meet other
people with osteoarthritis and learn their tips and
tricks for reducing and coping with joint pain.

Flexibility and stretching exercises: can
expand or preserve the range of motion and
elasticity in affected joints and thus relieve the
stiffness that leads to pain
low impact aerobic exercise
program :can aid in controlling weight, which in
turn lessens impact and stress on the joints
• Repeated motion of the joint is necessary to
maintain normal joint health

 The variety of options available to control pain is
extensive, including
Heat therapy prior to exercise to warm up stiff
muscles and joints and make them more easy to
stretch
Ice therapy or cold packs after exercise to cool
swollen joints
Elastic supports sometimes worn for several
hours, are often effective.

 Tai Chi. This Eastern exercise approach is
especially beneficial for building strength and
flexibility and balance, and provides moderate for
aerobic benefits. For elderly individuals, Tai Chi is
considered a relatively save form of exercise
because the movements are slow and fluid.
 It provides balance of body It is sometimes called
"moving meditation," because the focus is on
breathing and creating inner stillness - quieting
the mind, relaxing the body

 Yoga. Another Eastern exercise
approach, yoga is especially beneficial for building
 strength, balance and flexibility,
 control osteoarthritis pain.
 provides mental benefits, such as peace of mind
 reduce the feelings of stress and anxiety

 Pilates. strengthening program that slightly
elevates the heart rate and incorporates
stretching the limbs and joints to increase
flexibility.
 While this form of exercise is typically more
demanding than many forms of Tai Chi and yoga,
 pilates exercise is effective for building
strength, especially the in the core body muscles,
and is gentle on the joints.

 Exercise walking or using a treadmill,
stationary biking: exercise provide a good
aerobic workout with relatively little stress on the
joints. Stationary biking and the elliptical trainer
cause less stress on the spine than walking or using
a treadmill.
 Water therapy. When doing exercises in a
pool, the water provides enough resistance to help
build strength but it also stabilizes the body in a way
that open-air exercise cannot

Assistive devises : Different devices are used
like canes, electric-powered eat lift, raised toilet
seats,& shower bars can reduce the stress on
joint.
 Trance cutaneous nerve stimulation
(TENS): unit delivers mild electric current to
skin stimulating nerve fibers in the skin that may
interfere with the transmission of pain signals
from the arthritic joint.

 Magnetic belt
 Magnet application on joint
 Magnetized water
 Magnetic charged oil massage.
Magneto Therapy

Cortisone shots.
Lubrication injections.
Realigning bones
Joint replacement.
Treatment through surgery

 The diagnosis of osteoarthritis begins
with a medical history, or information
about health background
Important part of the diagnostic process
is the physical exam to find out how
arthritis is affecting your body.
Diagnosis

 It’s important to see doctor if you
experience symptoms
 Sudden swelling, warmth, redness along
with pain in any joint(s)
 Joint pain accompanied by a fever and/or
rash
 Severe pain that prevents you from using
the joint
Continue.

 Rest
 Exercise
 lose Weight
 Apply over the counter pain cream
 Use heat and cold to mange pain
 Use assistive devices
Preventions

 Osteoarthritis and rheumatoid arthritis is the
cause behind the joint symptoms.
 Osteoarthritis is caused by mechanical wear and
tear on joints
 Rheumatoid arthritis is an autoimmune disease in
which the body's own immune system attacks the
body's joints.
Difference Btw Osteo & Rheumatoid Arthritis
racteristic Rheumatoid arthritis Osteoarthritis
e at which the condition
ts
It may begin any time in life. It usually begins later in life.
ed of onset Relatively rapid, over weeks to
months
Slow, over years
ntsymptoms Joints are painful, swollen, and
stiff.
Joints ache and may be tende
but have little or no swelling.
ern of joints that are
cted
It often affects small and large
joints on both sides of the body
(symmetrical), such as both
hands, both wrists or elbows, or
the balls of both feet.
Symptoms often begin on
oneside of the body and may
spread to the other side.
Symptoms begin gradually
usually large weigh bearing
joint (knee, hip) or spine.
ration of morning
fness
Morning stiffness lasts longer
than 1 hour.
Morning stiffness lasts less
than 1 hour. Stiffness returns
at the end of the day or after
periods of activity.
sence of symptoms
cting the whole body
temic)
Frequent fatigue and a general
feeling of being ill are present.
Whole-body symptoms are
not present.

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SOC 101 Demonstration of Learning Presentation
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Osteoarthritis.

  • 2. Arthritis is inflammation of joints.. •Symptoms of arthritis; joint pain. Stiffness ( (worsen with age).
  • 3.  Types of arthritis are; osteoarthritis. rheumatoid arthritis. Continued..
  • 5.  Surgery Prevalence of OA Physical Therapy Risk Factors Preventions Difference between Osteoarthritis & Rheumatoid Arthritis Contents
  • 6.   Degeneration of joint cartilage and the underlying bone.  Often called wear-and-tear arthritis.  Occurs when the protective cartilage on the ends of our bones wears down over time.  It is most common form of arthritis. Definition of Osteoarthritis.
  • 7.
  • 8.  Cartilage;  Covers the ends of bones, which allows them to glide over each other.  It also helps in absorbing the shock of movement.  Top layer of cartilage break down and wears away consequently and the bones under the cartilage rub together. That causes; pain, swelling, and loss of motion of the joint.  Over time, the joint may lose its normal shape Explanation.
  • 10.   Bone spur extra bone growth that is not needed. • Sometimes, bits of bone or cartilage can break off and float inside the joint space, which causes more pain and damage. • Osteoarthritis gradually worsens with time, and no cure exists. Continue…..
  • 11.   Primary Osteoarthritis.  Secondary Osteoarthritis. Types of Osteoarthritis.
  • 12.   “wear and tear” osteoarthritis, more commonly diagnosed.  Spontaneous.  No specific causes.  Tend to develop around age 55 or 60.  Associate with aging.  Include joint pain, stiffness, and limitation of movement. Primary Osteoarthritis.
  • 13.   Specific cause such as  Injury.  An effect of obesity.  Genetics.  Inactivity  other diseases.  Tends to strike at an earlier age, around 45 or 50. Secondary Osteoarthritis.
  • 14.   Symptoms often develop slowly and worsen over time.  Signs and symptoms;  Pain  Tenderness  Stiffness  Loss of flexibility  Grating sensation  Bone spurs Symptoms.
  • 15.   Pain; Joint may hurt during or after movement  Loss of flexibility; patient may not be able to move their joint through its full range of motion  Stiffness; Joint stiffness may be most noticeable when you wake up in the morning or after a period of inactivity. Symptom’s Explanation.
  • 16.  Bone spurs; These extra bits of bone, which feel like hard lumps, may form around the affected joint. Grating sensation; Patient may hear or feel a grating sensation when he use the joint.  Tenderness; Joint may feel tender when you apply light pressure to it. Continue…..
  • 17.   OA occur when cartilage that cushions the end of bones in the joint detoriates over time.  smooth surface of cartilage become rough ,causing irritation.  Eventully,if the cartilage wear down competly,patient may be left with bone rubbing on bone causing ends of bone to become damage and joint become painful  causes of OA are not clear in some cases researches suspect that it’s combination of factors. Causes.
  • 18.   Factors that increase risk include;  Older age  Sex  Bone deformities  Joint injuries  Obesity  Certain Occupations  Other diseases Risk Factors
  • 19.  Older age. The risk of OA increases with age. Sex.  Women are more likely to develop osteoarthritis, though it isn't clear why. Bonedeformities. Some people are born with malformed joints or defective cartilage, which can increase the risk of OA. Explanation of RF..
  • 20.  Joint injuries. Injuries, such as those that occur when playing sports or from an accident, may increase the risk of osteoarthritis. Obesity. Carrying more body weight puts added stress on your weight-bearing joints, such as your knees. Continue..
  • 21.   Certain occupations. If your job includes tasks that place repetitive stress on a particular joint, that joint may eventually develop osteoarthritis.  Other diseases. Having diabetes, underactive thyroid, gout or Paget's disease of bone can increase risk of developing osteoarthritis. Continue….
  • 22.   OA is higher in women than men  In women it increases dramatically around the time of menopause. Prevalence of Osteoarthritis
  • 23.
  • 24.   Osteoarthritis is a degenerative disease that worsens over time. Joint pain and stiffness may become severe enough to make daily tasks difficult. Some people are no longer able to work. When joint pain is this severe, doctors may suggest joint replacement surgery. Complications
  • 25.  X-rays. Cartilage doesn't show up on X-ray images, but the loss of cartilage is revealed by a narrowing of the space between the bones in your joint. An X-ray may also show bone spurs around a joint. Many people have X-ray evidence of osteoarthritis before they experience any symptoms.  Lab tests:Analyzing blood or joint fluid can help pinpoint the diagnosis. Test
  • 26.  Imaging tests:Pictures of the affected joint can be obtained during imaging tests.  Blood tests. Blood tests may help rule out other causes of joint pain, such as rheumatoid arthritis.  Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce detailed images of bone and soft tissues, including cartilage. Continue..
  • 27.   Joint fluid analysis. Doctor may use a needle to draw fluid out of the affected joint. Examining and testing the fluid from joint can determine if there's inflammation and if pain is caused by gout or an infection  Arthroscopy: Arthroscopy to see inside the joint in order to determine the case of pain. During this small pain incision is made and small camera is inserted to see inside the joint. Continue.
  • 28.  There are 4 stages of OA Acute Osteoarthritis. Sub acute Osteoarthritis. Chronic Osteoarthritis. Degenerative Osteoarthritis. Stages..
  • 29.   Word acute in medical jargon means short-term and/or severe.  One might have acute pain (severe) for a short period of time.  When it comes to osteoarthritis, the acute stage is characterized by occasional joint pain. Short periods of time where joints—knees, hips, elbows, hands, fingers—are stiff and painful to move.  People in the acute state of osteoarthritis don’t think of themselves as having arthritis.  Ignore minor aches and pains.  But this is a big mistake. Acute OA
  • 30.   Osteoarthritis is a progressive disease. Without taking some action to arrest it in the acute stage  Some people think the weather may play a role, and that’s partly true.  Cold weather does cause stiffness and loss of flexibility in people with acute osteoarthritis. It can take a while for joints to warm up and allow flexibility to return.  Treatment; one of the very best natural treatments is Devil’s Claw extract
  • 31.   People who are in the sub acute stage of osteoarthritis are very much aware they have a problem with their joints.  This stage is characterized by localized joint pain.  People may feel extreme pain and stiffness in their fingers and hands, but their other joints function properly and painlessly. Sub acute OA
  • 32.   The thing to remember about subacute osteoarthritis is that “it’s not too late”.  At this stage, localized pain and stiffness can not only be relieved, but it can also be reversed. Like acute osteoarthritis Treatment. Devil’s Claw extract, glucosamine, boswellia, and curcumin can be useful in this stage.
  • 33.   If osteoarthritis has progressed to the chronic stage, you are probably in quite a bit of pain.  Movement in the chronic stage can be severely limited, and patient take prescription drugs (nonsteriodal anti-inflammatory drugs) designed to relieve the symptoms, but do nothing to address the cause of the disease.  These drugs often have unpleasant side effects. Chorionic OA
  • 34.   In chronic osteoarthritis, there is still hope. Treatment; Nature’s pharmacy contains some amazing treatments that can bring relief to those who are in the chronic stage.  Again, Devil’s Claw extract,glucosamine, chondroitin, betaine, and ginger extract.
  • 35.   Degenerative stage of osteoarthritis is truly unfortunate.  Characterized by a complete loss of cartilage surrounding the joint and the terrible pain of bone rubbing on bone.  People in the DS are often immobile, and wheelchair bound. They are also prescribed powerful narcotic pain killers to relieve the condition Degenerative OA
  • 36.   There's no known cure for osteoarthritis, but treatments can help to reduce pain and maintain joint movement Medications. Acetaminophen. No steroidal anti-inflammatory drugs . Narcotics. Treatment & Drugs.
  • 37.  A combination approach to treatment often works best. Doctor may suggest: Physical therapy.A physical therapist can work with patient to create an individualized exercise regimen that will strengthen the muscles around joint, increase the range of motion in joint and reduce pain. Physical Therapy
  • 38.  Occupational therapy.An occupational therapist can help you discover ways to do everyday tasks or do your job without putting extra stress on your already painful joint. For instance, a toothbrush with a large grip could make brushing your teeth easier if you have finger osteoarthritis. A bench in your shower could help relieve the pain of standing if you have knee osteoarthritis.
  • 39.  Braces or shoe inserts. Consider trying splints, braces, shoe inserts or other medical devices that can help reduce pain. These devices can immobilize or support joint to help you keep pressure off it.  A chronic pain class.  These classes teach skills that help to manage your osteoarthritis pain. And you'll meet other people with osteoarthritis and learn their tips and tricks for reducing and coping with joint pain.
  • 40.  Flexibility and stretching exercises: can expand or preserve the range of motion and elasticity in affected joints and thus relieve the stiffness that leads to pain low impact aerobic exercise program :can aid in controlling weight, which in turn lessens impact and stress on the joints • Repeated motion of the joint is necessary to maintain normal joint health
  • 41.   The variety of options available to control pain is extensive, including Heat therapy prior to exercise to warm up stiff muscles and joints and make them more easy to stretch Ice therapy or cold packs after exercise to cool swollen joints Elastic supports sometimes worn for several hours, are often effective.
  • 42.   Tai Chi. This Eastern exercise approach is especially beneficial for building strength and flexibility and balance, and provides moderate for aerobic benefits. For elderly individuals, Tai Chi is considered a relatively save form of exercise because the movements are slow and fluid.  It provides balance of body It is sometimes called "moving meditation," because the focus is on breathing and creating inner stillness - quieting the mind, relaxing the body
  • 43.   Yoga. Another Eastern exercise approach, yoga is especially beneficial for building  strength, balance and flexibility,  control osteoarthritis pain.  provides mental benefits, such as peace of mind  reduce the feelings of stress and anxiety
  • 44.   Pilates. strengthening program that slightly elevates the heart rate and incorporates stretching the limbs and joints to increase flexibility.  While this form of exercise is typically more demanding than many forms of Tai Chi and yoga,  pilates exercise is effective for building strength, especially the in the core body muscles, and is gentle on the joints.
  • 45.   Exercise walking or using a treadmill, stationary biking: exercise provide a good aerobic workout with relatively little stress on the joints. Stationary biking and the elliptical trainer cause less stress on the spine than walking or using a treadmill.  Water therapy. When doing exercises in a pool, the water provides enough resistance to help build strength but it also stabilizes the body in a way that open-air exercise cannot
  • 46.  Assistive devises : Different devices are used like canes, electric-powered eat lift, raised toilet seats,& shower bars can reduce the stress on joint.  Trance cutaneous nerve stimulation (TENS): unit delivers mild electric current to skin stimulating nerve fibers in the skin that may interfere with the transmission of pain signals from the arthritic joint.
  • 47.   Magnetic belt  Magnet application on joint  Magnetized water  Magnetic charged oil massage. Magneto Therapy
  • 48.  Cortisone shots. Lubrication injections. Realigning bones Joint replacement. Treatment through surgery
  • 49.   The diagnosis of osteoarthritis begins with a medical history, or information about health background Important part of the diagnostic process is the physical exam to find out how arthritis is affecting your body. Diagnosis
  • 50.   It’s important to see doctor if you experience symptoms  Sudden swelling, warmth, redness along with pain in any joint(s)  Joint pain accompanied by a fever and/or rash  Severe pain that prevents you from using the joint Continue.
  • 51.   Rest  Exercise  lose Weight  Apply over the counter pain cream  Use heat and cold to mange pain  Use assistive devices Preventions
  • 52.   Osteoarthritis and rheumatoid arthritis is the cause behind the joint symptoms.  Osteoarthritis is caused by mechanical wear and tear on joints  Rheumatoid arthritis is an autoimmune disease in which the body's own immune system attacks the body's joints. Difference Btw Osteo & Rheumatoid Arthritis
  • 53. racteristic Rheumatoid arthritis Osteoarthritis e at which the condition ts It may begin any time in life. It usually begins later in life. ed of onset Relatively rapid, over weeks to months Slow, over years ntsymptoms Joints are painful, swollen, and stiff. Joints ache and may be tende but have little or no swelling. ern of joints that are cted It often affects small and large joints on both sides of the body (symmetrical), such as both hands, both wrists or elbows, or the balls of both feet. Symptoms often begin on oneside of the body and may spread to the other side. Symptoms begin gradually usually large weigh bearing joint (knee, hip) or spine. ration of morning fness Morning stiffness lasts longer than 1 hour. Morning stiffness lasts less than 1 hour. Stiffness returns at the end of the day or after periods of activity. sence of symptoms cting the whole body temic) Frequent fatigue and a general feeling of being ill are present. Whole-body symptoms are not present.