Inflammatory Bone Disorders: Osteoarthritis vs Rheumatoid

One of the most confusing topics of inflammatory bone disorders is distinguishing osteoarthritis from rheumatoid arthritis. Which is which and how does one differ from the other?

Osteoarthritis and rheumatoid arthritis are both conditions affecting the bones, specifically, the joints and cartilages. However, certain characteristics set them apart.

Arthritis: A Quick Overview

Whenever you think of arthritis, you should think about the joints that link the bones to each other. But the main factor that these joints have which are directly affected by arthritis is the cartilage.

Cartilages make sure that the bones don’t rub each other; thus, creating friction which causes arthritis. The main function of cartilages is to serve as a cushion between joints so they don’t collide with each other which would result in an insurmountable amount of pain.


To effectively facilitate identifying the difference between osteoarthritis and rheumatoid arthritis, we must first focus on one condition and then go to the next. At this point, we’ll be aiming our attention to osteoarthritis.

“Osteo” means bone; remember that. Osteoarthritis, on the other hand, technically means that there is decreased cushion or cartilages between joints.

Crackling Bones

One of the major manifestations of osteoarthritis is the crackling of bones, especially when moving up and around. Crackling occurs due to the bone on bone interaction.

Interventions for Crackling Bones

  1. Cartilage coating

Cartilage transplant is not the immediate solution. However, the doctor can perform a surgery wherein the affected bones or joints are coated with a type of synthetic gel or metal to prevent the bones from further rubbing.

  1. Cortisone shots

But the primary intervention usually given to clients with osteoarthritis is the administration of cortisone shots. Cortisone shots bring down the inflammation caused by constant friction by being the buffer in between the joints.

How are cortisone shots given?

By infusing a big needle into the affected joints, cortisone is introduced. This management technically fills up space in between with some artificial cushion or artificial cartilage for quite some time.

However, after a couple of weeks, some cortisone spills out and disappears. For this reason, doctors would advise their clients to come back to get more cortisone shots once it wears off.

Osteoarthritis: Other Signs and Symptoms

The weight-bearing joints are primarily affected by osteoarthritis so you have to expect that the chief complaint of your client would focus particularly on those bones.

Aside from the crackling of bones, which is the primary manifestation of osteoarthritis and happens to 99% of the older population, you also have joint pain.

Osteoarthritis is most common in geriatric clients because as their age increase, their cartilages decrease and degenerate. Also, the constant rubbing of their joints caused cartilage depletion, and this is due to the activities they’ve engaged in through the years.

Nursing Education

Since osteoarthritis affects weight-bearing joints and bones (hip and knees), you have to instruct your client to avoid exercises that would require lifting heavy items or rigorous activities that would primarily affect and cause stress on those areas. So, weight-bearing exercises are a no-no.

A Contraindication that Contradicts

The thing about weight-bearing exercises is that they are actually good for the bones because these types of activities build-up muscle and muscle helps in surrounding the bones, keeping them tight. Tight bones prevent osteoporosis or bone decalcification.

However, at this point of having osteoarthritis, you either choose whether to not make the bones brittle or to decrease the pain caused by the condition. It’s a choice between what’s going to cause more pain and what’s better for the client.

Diagnosing Osteoarthritis

To diagnose osteoarthritis, a laboratory test known as osteocyte test study is done. In this test, a biopsy of the joint is done to assess how much osteocytes are inside the bone.

Types of Osteoarthritis

Lastly, there are two types of osteoarthritis you have to be aware of, namely:

  1. Bouchard’s nodes – little nodules appear around the fingers
  2. Heberden’s nodes – swellings around the joints near the fingertips

So, that’s our osteoarthritis lecture. In our next lecture, we’ll be tackling rheumatoid arthritis.

For other nursing-related topics, head on to our SimpleNursing YouTube channel and website.

See you there!