Discussion Question

Please answer the questions below, minimum of 250 words

Both osteoarthritis and rheumatoid arthritis present with several of the same manifestations, such as joint pain and stiffness. How do the two disorders differ?
A child born with osteogenesis imperfecta is at risk for pathological fractures.

Explain the pathophysiology of this disorder and the associated risk factors.

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Solution

Osteoarthritis and Rheumatoid Arthritis

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Osteoarthritis and rheumatoid arthritis are both pathologies of the joints although they differ considerably. For instance, osteoarthritis is characterized by degeneration of the articular cartilage and the underlying bone secondary to chronic tear and wear while rheumatoid arthritis is a chronic inflammatory autoimmune disorder of unknown aetiology characterized by pain, swelling, stiffness, and destruction of synovial joints (Mohammed et al., 2020). Similarly, osteoarthritis mostly affects elderly patients with incidence common at 50 years of age whereas rheumatoid arthritis can commence at any time and progress rapidly. Additionally, rheumatoid arthritis, as opposed to osteoarthritis, presents with extra-articular manifestations including rheumatoid nodules, constitutional symptoms, ocular and pulmonary pathologies among others (Mohammed et al., 2020). Also, osteoarthritis typically affects one particular area or joint contrasted to the widespread involvement of joints in rheumatoid arthritis. Finally, the laboratory findings in Rheumatoid arthritis include elevated ESR and CRP plus positive rheumatoid factor while in osteoarthritis, the ESR and CRP are normal and rheumatoid factor is negative.

Osteogenesis Imperfecta

Brittle bone disease is a result of an array of genetic defects, majorly autosomal dominant mutations in COLA1 and COL1A2 genes with resultant decreased formation of hydrogen and disulfide bonds between type 1 preprocollagen molecules. This leads to diminished triple helix formation. Consequently, there is decreased normal type 1 collagen production which impairs bone matrix formation (Subramanian & Viswanathan, 2021). Additionally, autosomal recessive forms of osteogenesis imperfecta are existent too. These forms result from defects in non-collagen proteins that take part in post-translational modifications or triple helix formations. The principal risk factor is heredity, with a 50% chance of the disease manifesting in an offspring of a parent with the condition.

References

Mohammed, A., Alshamarri, T., Adeyeye, T., Lazariu, V., McNutt, L.-A., & Carpenter, D. O. (2020). A comparison of risk factors for osteo- and rheumatoid arthritis using NHANES data. Preventive Medicine Reports20(101242), 101242. https://doi.org/10.1016/j.pmedr.2020.101242

Subramanian, S., & Viswanathan, V. K. (2021). Osteogenesis Imperfecta. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK536957/