Explain the pathophysiology of an autoimmune disease in relation to destruction of the synovial joints, capsule, and membrane to a specific disease of choice.
The chosen disease is rheumatoid arthritis. This is an immune-mediated inflammatory disease (IMID) where antibodies are produced against the joints’ proteins. The autoantibodies stimulate inflammatory reactions in the joints, which result in the destruction of the synovial joints, capsule, and synovial membrane. Rheumatoid arthritis results in inflammatory reactions because of the production of tumour-like aggressive synoviogenic cell elements (TLP). These elements result in the secretion of several types of proteases in the joints, like cartilage-degrading metalloproteases. This results in the destruction of cartilage. The cartilage is always important in the prevention of friction between two bones that articulate at a joint. The antibodies that are secreted also result in the destruction of the capsule and the synovial membranes. Therefore, rheumatoid arthritis has an inflammatory and degradation effect on all the structures of the joints hence reduction in the joint space and swelling hence pain and limitation in the range of motion.
Compare and contrast signs and symptoms of OA (osteoarthritis) to RA (Rheumatoid arthritis).
The common clinical features that are the same in osteoarthritis and in rheumatoid arthritis are pains in the joints, stiffness in the joints and swelling. In addition, there is a limitation in the range of motion in both rheumatoid arthritis and osteoarthritis.
On the differences, RA usually affects the small joints in hands and feet while OA affects the joints that are used most in the hands and spine and the joints that bear the most weight, like the hip and knees.
RA causes morning stiffness that can last an hour or even more while in OA, the stiffness usually improves within 30 minutes.
RA also has some systemic clinical features like fatigue, low fevers, low appetite and rheumatoid nodule under the skin. All these are absent in OA. There is also more inflammation in patients with rheumatoid arthritis as compared to people with osteoarthritis.
RA affects joints in a symmetrical manner, meaning it affects the same joints on the bilateral sides of the body as compared to OA, which will affect only a few joints on one side of the body (van den Bosch, 2021).
Describe the difference between Heberden’s nodes vs Bouchard’s nodes.
Bouchard’s nodes are a result of advanced osteoarthritis in the hands. They are bony prominences that are formed in the middle finger or the proximal interphalangeal joints. They are also less common as compared to the Heberden nodes.
Heberden nodes are bony swelling of the distal interphalangeal finger joint because of osteoarthritis. These are more common in patients with osteoarthritis as compared to Bouchard nodes.
What is Gouty arthritis, and how does it differ from OA?
Gouty arthritis is a form of an inflammatory disease that occurs when there is excess uric acid which is sharp crystals that may form in the big toe or other joints. The pains and the swelling are called gout attacks. The other common symptoms of gouty arthritis are intense pain, redness, stiffness, swelling, tenderness and warmth. The difference between gouty arthritis and OA is that gouty arthritis results from uric acid crystals forming in the joints, while OA results from wear and tear of the cartilage in the joints.