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Osteoarthritis - Conditions with Similar Symptoms

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of the most common form of arthritis.

Alternative Names

Arthritis - osteoarthritis

Conditions with Similar Symptoms:

Numerous conditions cause symptoms of joint aches and pains. Something as simple as sleeping on a bad mattress or as serious as cancer can mirror symptoms of osteoarthritis. Other problems that can cause aches and pains in the joints include physical injuries, infections, tendinitis, and poor circulation. A number of rare genetic diseases attack the joints.

Osteoarthritis can generally be distinguished from other joint diseases by considering several factors together:

Osteoarthritis usually occurs in older people and is located in only one or a few joints.
The joints are less inflamed than in other arthritic conditions.
Progression of pain is usually gradual.

Below are a few of the most common disorders that can be confused with, or may even accompany, osteoarthritis.

Rheumatoid Arthritis

Osteoarthritis may be confused with rheumatoid arthritis, particularly when osteoarthritis affects multiple joints in the body. Rheumatoid arthritis begins in the synovial membrane rather than the cartilage. It normally occurs earlier in life than osteoarthritis, often striking people in their 30s and 40s. Rheumatoid arthritis affects many joints, and often occurs symmetrically on both sides of the body. People with rheumatoid arthritis generally have morning stiffness that lasts for at least an hour. (Stiffness from osteoarthritis usually clears up within half an hour.) Although osteoarthritis can occasionally cause swollen, red joints, this appearance is much more typical of rheumatoid arthritis and other types of inflammatory arthritis.

X-rays of joints affected with rheumatoid arthritis show changes in the bones that differ from those occurring in osteoarthritis. In rheumatoid arthritis, blood tests often show a specific antibody, known as rheumatoid factor, which is not present with osteoarthritis. In another blood test, levels of a factor called erythrocyte sedimentation rate (ESR) are often elevated in rheumatoid arthritis, but they are generally normal in osteoarthritis. Rheumatoid arthritis also does not usually show up in the fingertips where osteoarthritis is common.

Rheumatoid arthritis is a body-wide (systemic) autoimmune disease that initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.

Click the icon to see an image of osteoarthritis vs. rheumatoid arthritis.

Chondrocalcinosis

Chondrocalcinosis is a disease in which calcium crystals known as CPPD (calcium pyrophosphate dihydrate) accumulate in the joints. This condition affects about 25% of the population and can accompany and even worsen osteoarthritis. Chondrocalcinosis has been called pseudogout or pseudo-osteoarthritis, the latter particularly when it affects the knees. A doctor can usually differentiate between the two disorders, however, because chondrocalcinosis usually damages other joints (such as wrists, elbows, and shoulders) that are not normally affected by osteoarthritis. The condition may explain why some patients with osteoarthritis benefit from colchicine, a drug used for gout and other crystal-induced joint diseases.

Charcot's Joint

Charcot's joint occurs when an underlying disease, usually diabetes, causes nerve damage in the joint, which leads to swelling, bleeding, increased temperature, and changes in bone. There may be a loss of sensation that leads to an increased risk of injury from overuse.

Resources

www.rheumatology.org -- American College of Rheumatology
www.arthritis.org -- Arthritis Foundation
www.niams.nih.gov -- National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.aaos.org -- American Academy of Orthopaedic Surgeons
www.fda.gov/cder/drug/infopage/cox2 -- FDA NSAID and COX-2 Inhibitor Information

References

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Brouwer RW, Raaij van TM, Bierma-Zeinstra SM, et al. Osteotomy for treating knee osteoarthritis. Cochrane Database Syst Rev. 2007;(3):CD004019.

Buckland-Wright JC, Messent EA, Bingham CO 3rd, et al. A 2 yr longitudinal radiographic study examining the effect of a bisphosphonate (risedronate) upon subchondral bone loss in osteoarthritic knee patients. Rheumatology (Oxford). 2007;46(2):257-264.

Cepeda MS, Camargo F, et al. Tramadol for osteoarthritis: a systematic review and metaanalysis. J Rheumatol. 2007;34(3):543-555.

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Reviewed last on: 8/5/2008
Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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