Response to Student Post

Please respond to the student post below, minimum 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?

Osteoarthritis involves the wear and tear on joints affecting the cartilage that caps the bones in your joints providing cushion. Rheumatoid arthritis is an autoimmune disease that attacks the linings of the joints causing degradation from the body’s own immune system. While osteoarthritis generally evolves over time and progresses at a rate in line with the amount of wear and tear the body has been put under also usually in advanced age, rheumatoid arthritis can begin any time in a patient’s life and can progress rapidly. Osteoarthritis occurs when the smooth cartilage of a joint wears out in an isolated joint. Rheumatoid arthritis has asymmetrical nature. For example, maybe in the hips bilaterally. Symptoms of fever, fatigue, anaemia, and loss of appetite may also be present (McCance & Huether, 2019).

A child born with osteogenesis imperfecta is at risk for pathological fractures. Explain the pathophysiology of this disorder and the associated risk factors.

Osteogenesis imperfecta is a result of a defect involving decreased type 1 collagen production resulting in insufficient osteoid production. Two pro-alpha-1 chains and one pro-alpha-2 chain make up type I collagen, which forms the main protein of the extracellular membrane of skin, bones, tendons, etc. Patients have a genetic defect resulting in quantitative and qualitative abnormalities in type I collagen molecules. This disorder is inheritable in an autosomal dominant, autosomal recessive, or spontaneous mutation pattern. These abnormalities create brittle bones The greatest risk factor is hereditary. If one parent has osteogenesis imperfecta, a child has a 50 per cent chance of having the condition. The most common forms of osteogenesis imperfecta are inherited and can usually be traced through the family(Subramanian, 2021).

Reference

McCance, K.L., & Huether, S.E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.

Subramanian S, Viswanathan VK. Osteogenesis Imperfecta. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536957/

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Solution

Response to Student Post

Hello colleague. After reviewing your discussion on osteoarthritis and rheumatoid arthritis, I agree with you that the two conditions significantly vary. For instance, osteoarthritis is a degenerative disorder with a slower gradual progression as opposed to rheumatoid arthritis which is a chronic inflammatory autoimmune disorder with a rapid progression. In addition to your mentioned differences, genetic predisposition plays a crucial role in the development of rheumatoid arthritis despite the condition being idiopathic (Ng & Azizudin, 2020). This is contrary to osteoarthritis which is secondary to wear and tear of the articular cartilage.

The joint stiffness of osteoarthritis is mild in the morning and occurs after a few hours of inactivity during the day while the joint stiffness of rheumatoid arthritis is for prolonged hours and takes a long to subside. Furthermore, the pharmacological management of rheumatoid arthritis chiefly involves the use of immunosuppressants while analgesics are the mainstay pharmacologic agents in the treatment of osteoarthritis (Ng & Azizudin, 2020). Radiological findings in osteoarthritis include osteophytes, subchondral sclerosis, and asymmetric joint space narrowing while they include symmetric joint space loss and osteopenia in rheumatoid arthritis.

Your discussion on the pathophysiology and risk factors for osteogenesis imperfecta was elaborate and extensive. However, this most common inheritable connective tissue disorder can be subdivided into several types. Types I -IV are autosomal dominant while types VI-XIII are autosomal recessive(Sam & Dharmalingam, 2017). It is vividly clear that the pathophysiological basis of osteogenesis imperfecta is genetic defects that translate into defects of collagen synthesis, structure, processing, in collagen posttranslational modifications, collagen folding, and cross-linking. Consequently, defects in bone mineralization and risk of pathological fractures(Sam & Dharmalingam, 2017). Finally, am in total agreement that the most important risk factor for osteogenesis imperfecta is heredity.

References

Ng, J. Y., & Azizudin, A. M. (2020). Rheumatoid arthritis and osteoarthritis clinical practice guidelines provide few complementary and alternative medicine therapy recommendations: a systematic review. Clinical Rheumatology39(10), 2861–2873. https://doi.org/10.1007/s10067-020-05054-y

Sam, J. E., & Dharmalingam, M. (2017). Osteogenesis imperfecta. Indian Journal of Endocrinology and Metabolism21(6), 903–908. https://doi.org/10.4103/ijem.IJEM_220_17

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