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Autoimmune Diseases. 1. Explain the pathophysiology of an autoimmune disease in relation to destruction of the synovial joints, capsule, and membrane to Rheumatoid arthritis.
2. Compare and contrast signs and symptoms of OA ( osteoarthritis) to RA (Rheumatoid arthritis).
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3. Describe the difference between Heberden's nodes vs Bouchards nodes.
4. What is Gouty arthritis and how does it differ from OA ( osteoarthritis).
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Pathophysiology of Rheumatoid arthritis in relation to destruction of the synovial joints, capsule, and membrane.
Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation and progressive destruction of joints, primarily affecting synovial joints. The pathogenesis of RA is complex and involves genetic, environmental, and immunological factors. The hallmark of RA is the infiltration of immune cells, mainly T and B lymphocytes, into the synovial membrane, which is normally a thin, avascular lining that covers the inner surface of the joint capsule. The synovial membrane contains fibroblast-like synoviocytes (FLSs), which produce synovial fluid that nourishes and lubricates the joint. In RA, activated FLSs produce pro-inflammatory cytokines, chemokines, and metalloproteinases that promote synovial inflammation and damage to the joint structures.
The inflammation and proliferation of FLSs result in the formation of pannus, an invasive and erosive tissue that destroys cartilage, bone, and other joint structures. The pannus invades the joint space and erodes the articular cartilage and subchondral bone, leading to the formation of bony erosions, joint deformities, and loss of joint function. The inflammation also affects the joint capsule, which becomes thickened and fibrotic, causing joint stiffness and restricted movement. The destruction of the synovial membrane and capsule leads to the release of cytokines and other inflammatory mediators into the bloodstream, causing systemic manifestations of RA such as fatigue, fever, and weight loss.
References:
Smolen, J. S., Aletaha, D., & McInnes, I. B. (2016: 2024 - Do my homework - Help write my assignment online). Rheumatoid arthritis. The Lancet, 388(10055), 2023-2038. https://doi.org/10.1016/S0140-6736(16)30173-8
Scott, D. L., Wolfe, F., & Huizinga, T. W. (2010 - Essay Writing Service: Write My Essay by Top-Notch Writer). Rheumatoid arthritis. The Lancet, 376(9746), 1094-1108. https://doi.org/10.1016/S0140-6736(10)60826-4
Signs and symptoms of OA (osteoarthritis) compared to RA (Rheumatoid arthritis)
OA and RA are two common types of arthritis that affect joints and cause pain, stiffness, and functional impairment. However, they have distinct differences in their pathophysiology, clinical features, and treatment. OA is a degenerative joint disease that results from the wear and tear of joint structures, mainly cartilage, due to aging, mechanical stress, or metabolic factors. OA typically affects weight-bearing joints, such as knees, hips, and spine, and manifests with pain, stiffness, crepitus, and loss of range of motion. The pain in OA is usually worsened by activity and relieved by rest, and it may be localized to the joint or referred to adjacent structures. The joint inflammation in OA is mild or absent, and there is no systemic involvement.
In contrast, RA is an autoimmune disease that affects multiple joints symmetrically and causes chronic inflammation, synovitis, and joint destruction. RA typically affects smaller joints, such as fingers, wrists, and feet, but can also involve larger joints, such as shoulders and knees. The onset of RA is usually insidious, with symptoms such as morning stiffness, fatigue, malaise, and weight loss, preceding joint pain and swelling. The joint pain in RA is typically bilateral and symmetric, and it may be accompanied by erythema, warmth, and tenderness. The joint inflammation in RA is often severe
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