26
the guardians
The HEALTH | APRIL, 2018
Differentiating
rheumatoid arthritis
and osteoarthritis
O
STEOARTHRITIS and
rheumatoid arthritis are
forms of inflammatory
arthritis. What are the
difference between the
two, you may ask?
UITM consultant orthopaedic sur-
geon and senior lecturer Dr Mohamed
Faizal Hj Sikkandar explained to The
HEALTH that inflammation means fluid
being produced in response to a disease
or damage, which is part of a repairing
process.
“So, inflammatory arthritis - the
classical example would be rheumatoid
arthritis. Basically osteoarthritis and
rheumatoid arthritis are diseases of the
elderly from 6o years of age onwards.
Both occurs to the older age group,” he
said.
Both have different presentations.
He pointed out that firstly, rheumatoid
arthritis really starts with manifesta-
tions, symptoms over the small joints,
basically at the hand so patients would
present with swellings of the joints of
the hands while in advanced rheumatoid
arthritis - the joins of the hands will be
deformed. There will be some deviation
of the joints.
“For osteoarthritis, usually presenta-
tion would be larger joins - knee being
the usual joint being affected. So again,
symptoms, affecting the knee include
pain, swelling, and in advanced stages
the knees would be bent outwards.”
“Besides the difference in presenta-
tion, we see differences in investigations
as well. Typical investigations done for
both kinds of arthritis would be x-ray,”
he said.
The x-ray findings defer that in
rheumatoid arthritis, the joint space
are narrowed with spurs with some
destruction of the joint, while very
marked changes in osteoarthritis would
be spurs as well. The first change include
narrowing of the space — and the hall-
mark difference in x-ray findings in both
forms of arthritis would be the sub-joint
involved.
Understanding
symptoms and how
to detect them
before the age of 60
by NURUL AIN
HUDA ABDULLAH
ainhuda@revonmedia.com
Normal joins
(Above) Picture shows eroded knee for
Osteoarthritis.
(Bottom left and right) Knee deformity
that is seen in Osteoarthritis patients.
Are you
suffering
from dental
dryness?
“When we speak on the difference
between osteoarthritis and rheumatoid
arthritis in the knee, we should know
that normal joints are made up of three
components; the inner joint, the outer
joint and the patellofemoral joint or the
joint between the knee cap and the thigh
bone.”
“In osteoarthritis typically the medial
joins would be involved first - the inner
joins of the knee. In rheumatoid arthritis
of the knee - the outer joins being affected
first are the lateral joins. And often we see
the patellofemoral joint being involved as
well in rheumatoid arthritis,” he said.
To simplify, rheumatoid arthritis and
osteoarthritis in the age group differ in
presentation. Rheumatoid arthritis affect
small joints first, then affects larger joints,
while osteoarthritis affects large joints
first, with occasionally presentation in
small joints. Faizal pointed out that the
other difference, is the gender.
“The rheumatoid arthritis is rather a
sexist disease. It affects ladies more often
than men. It’s a lot to do with hormones,
genetics play a part,” he said.
Larger joins are more affected in
osteoarthritis because the male gender
typically have larger body sizes - so it
affects larger joints first.
“The other difference would be
investigations, where we’d see derange-
ment in arthritis. This is also a criteria
to confirm the diagnosis of rheumatoid
arthritis where we check specific blood
which include rheumatoid factors such
as double stranded DNA,” he explained.
Symptoms to detecting
arthritis before 60 years of age
“Whereas in osteoarthritis, the diagnosis
is rather straight forward - when a doctor
sees a patient coming in with large joint
involvement, bad knees, doctors would
know that it is osteoarthritis.”
“Fingers comes in much later, but it
is a rare manifestation for osteoarthritis,
whereas for rheumatoid arthritis — it’s
fingers first then the large joints.
“For osteoarthritis - its large joints
first, then if ever it happens small joins,”
he added.
Early symptoms for both forms of
arthritis include on-of pain which comes
even at rest —pain which comes with
specific movements, postures, or specifi-
cally after trauma such as sports injury.
Other presentation include swelling
which is usually on-and-of, crepeters
which are sounds of the movement of
joins and deformity which comes later
on, which is an advanced form of the
disease.
D
RY mouth can severely
affect your oral health
and quality of life. This
however, is not part of ageing
and should be prevented and
treated.
Bala Dental Surgery den-
tist, Dr Balasubramaniam
R explained that; in normal
circumstances, medications
should not have any effect,
unless it causes specifically
dryness of the mouth.
“If any medications should
cause dental dryness, then it
would be best to discontinue
with it. Otherwise, any other
types of medications should
The country’s
population is
moving towards
an aged nation by
2030, where it is
estimated that
15 per cent of our
population will be
aged 60 years and
above.
– Health director-
general Datuk
Seri Dr Noor
Hisham Abdullah
Although a dry mouth is common
among older adults, it is not part of
ageing and should be treated.
123rf
“Basically osteoarthritis and rheumatoid
arthritis are diseases of the elderly from
6o years of age onwards.” Dr Mohamed
Faizal Hj Sikkandar
not be an issue,” he said.
However, he pointed out that
medications with very sw