Comparison chart

Genetic
Factors
Gender

Age of
onset
Severity
Speed of
onset
Disease
Process
Cause

Presence
of
symptom
s
affecting
the
whole
body
(systemic
)
Joint
symptom
s

Pattern
of joints
that are
affected

pain with

Osteoarthritis
Family HX of OA
women
Common in both men and
women. Before 50 more
men than women, after
50 more women than men
Over 60

Rheumatoid Arthritis
RA and Leukocyte antigenfemale reproductive
hormones, Epstein-Barr virus
Affects more women than
men

Gout
Family history of gout

35-45 years old

more common in men

and in women after
menopause

Less severe
Slow, over years

Severe
Rapid, within a year

usually over 35 years of

age in men and after
menopause in females
Severe
Sudden onset

Normal wear and tear

(chronic degenerative)
wear and tear associated
with aging or injury, also
caused by injuries to the
joints, obesity, heredity,
overuse of the joints from
sports
Systemic symptoms are
not present. Localized
joint pain (Knee and hips)
but NO swelling Pain
severity is important
(mechanical,
inflammatory, nocturnal,
sudden)

chronic Autoimmune

metabolic disease

Classified as an autoimmune
disease, No real known
cause. Connection between
environmental and genetic
factors; female reproductive
hormones
Dull pain and inflammation
Frequent fatigue (afternoon),
stiffness, ulnar deviation,
muscle atrophy, swelling of
the knuckles , synovial
thickness complications:
joint fail, depression,
osteoporosis, infections
surgical complications

deposition of uric acid

around joints

Joints painful but without

swelling; affects joints
asymmetrically; affects
bigger joints such as hips
& knees. Localized with
variable, progressive
course
Asymmetrical & may
spread to the other side.
Symptoms begin
gradually and are often
limited to one set of
joints, usually the finger
joints closest to the
fingernails or the thumbs,
large weight-bearing
joints
movement increases pain

Joints are painful, swollen,

and stiff; affects joints
symmetrically; affects
smaller joints such as hands
& ankles. Systemic with
exacerbations and
remissions
Symmetrical - often affects
small and large joints on
both sides of the body, such
as both hands, both wrists
or elbows, or the balls of
both feet

joints are hot, red

swollen and extremely
painful

movement decreases pain

Movement increase pain

Chills and a mild fever

along with a general
feeling of malaise may
also accompany the
severe pain and
inflammation

Asymmetrical - Joint of
the big toe most
commonly affected.
other joints affected are
of ankle, heel, knee,
wrist, fingers, elbow etc.

movemen
t
Associate
d
symptom
s

(no systemic symptoms)

fatigue, muscle weakness,
fever, organ involvement;
Bony enlargement,
deformity, instability,
restricted movement,
joint locked, sleep
disturbance, depression,
comorbid conditions
(bursitis, fibromyalgia,
gout)
local
inflammation/effusion
sometimes
Herberden's & Bouchard's
nodes

Frequent feelings of "being

sick inside," with fevers,
weight loss, or involvement
of other organ systems.
carpal tunnel Extra-articular
manifestations: nodules,
vasculitis, pulmonary,
cardiac, skin (vasculitis), eye
(Sjorgen's syndrome,
scleritis

Tophi may form. These

are large masses of uric
acid crystals, which gets
collect in the joints and
damage it. They also
gets collected in the
bone and cartilage, such
as in the ears.

Common

Common

Present, especially on
extensor surfaces. Swan
neck deformity. Biopsy
important to eliminate gouty
tophi

Assessm
ent

One or several joints;

enlarged, cool, and hard
on palpation

Radiologi
c findings

Loss of joint space and

articular cartilage, routine
wear and tear
osteophytes, sclerosis,
cysts, loose bodies,
alignment

Joints are swollen, red,

warm, tender, and painful;
several joints involved; Extra
articular: Rheumatoid
nodules, Sjogrens
syndrome, Felty syndrome
Bony erosions, soft tissue
swelling, angular deformities

Tophi form in
the joints, cartilage, bon
es, and other places
throughout the body.
Sometimes, tophi break
through the skin and
appear as white or
yellowish-white,
chalky nodules.
Warmth, pain, swelling,
and extreme tenderness
in a joint, usually a big
toe joint. Pain often
starts during the night.

Diagnosis

X-ray, pain assessmentperarticular and articular

source of pain, presence
of deformity, evidence of
muscle wasting, local
inflammation.
asymmetrical joints
Rheumatoid Factors (RF)
negative, transient
elevation in ESR related
to synovitis

Effusions

Nodules

Lab
findings

1- Anemia (ferritin, ion. ion

binding capacity)
2- bone (including ALP) 3Inflammatory markers (C
reactive protein and ESR)

RF positive, increased ESR &

CRP, antinuclear antibody,
arthrocentesis

Absence of periarticular
osteopenia, eccentric
erosions. Typical
appearance: presence of
well-defined punchedout erosions with
sclerotic margins in a
marginal and juxtaarticular distribution,
with overhanging edges.
X-ray, serum uric acid
levels, urinary uric acid,
synovial fluid analysis:
Needles of urate
crystals seen on
polarizing microscopy.
RF negative, elevated
serum uric acid, check
level urinary uric acid

Treatmen
t

NSAIDs (short term use)

Acetaminophen,
Analgesics, exercise

NSAIDs, Steroids
(Prednisone), DMARDs
(Methotrexate), Antimalarial
(Plaquenil), Corticosteroids

NSAIDs, Colchicine,
steroids, Urocosuric