donohue 11.8

Rheumatoid arthritis and osteoarthritis have one thing in common – joint pain

Dear Dr. Donohue: Would you explain how physicians determine if a patient has rheumatoid arthritis or osteoarthritis? – R.T.

Aside from affecting joints, rheumatoid arthritis and osteoarthritis are as different as day and night.

Rheumatoid arthritis is a “systemic” disease. Systemic diseases affect many body organs and tissues. Rheumatoid arthritis arises from an immune attack on body organs by its own immune system. Joints are only one target. The coverings of the heart and lungs can be inflamed. Rheumatoid nodules — bumps on the skin — often pop up. The disease can involve eyes. It inflames blood vessels.

Rheumatoid arthritis most commonly settles in knees, ankles, shoulders, elbows and wrists. The large knuckles where the fingers join the hand are often swollen and painful.

Osteoarthritis is the No. 1 kind of arthritis throughout the world. It is not a systemic disease. It stays exclusively in joints.

With osteoarthritis, the cartilage that protects joints crumbles. Bone rubs against bone. The joint becomes painful and stiff. What causes cartilage disintegration is an unsolved matter. In the past, wear and tear was the facile explanation, but wear and tear is not the entire story.

Osteoarthritis victimizes a few different joints from rheumatoid arthritis. It strikes the feet — in particular, the base of the big toe. Hips, knees and spine are other osteoarthritis sites. In fingers, the joint directly below the fingernail is a favorite place for osteoarthritis.

It is not too difficult to differentiate the two. In addition, blood tests for rheumatoid arthritis settle any question about which arthritis a patient has.

People seeking more information on arthritis can obtain the arthritis report by writing: Dr. Donohue — No. 2, Box 536475, Orlando, FL. Include a self-addressed, stamped (55 cents), No. 10 envelope and $3. Please allow six weeks for delivery.

Readers may write Dr. Donohue at P.O. Box 536475, Orlando, FL 32853-6475.