Living with chronic joint pain can be a challenging experience, and for some individuals, this pain may be caused by more than one type of arthritis. One such combination is the coexistence of Osteoarthritis (OA) and Rheumatoid Arthritis (RA). In this blog, we will delve into the possibility of having OA and RA simultaneously, explore their prevalence, discuss how blood tests and X-rays aid in distinguishing between the two conditions, and provide insights on identifying the type of arthritis you may have.
Can you have OA and RA simultaneously?
While OA and RA are distinct types of arthritis, it is indeed possible to have both conditions concurrently. Osteoarthritis is primarily characterised by the gradual breakdown of joint cartilage, typically affecting weight-bearing joints such as knees, hips, and spine. On the other hand, Rheumatoid Arthritis is an autoimmune disorder that causes chronic inflammation, primarily targeting the lining of the joints, normally the smaller joints line elbows and hands. Although they have different underlying causes, it is not uncommon for individuals to develop OA and RA simultaneously, leading to a more complex arthritis picture.
How common is it to have OA and RA together?
The exact prevalence of having both OA and RA is not well-established. However, studies suggest that the coexistence of these conditions is relatively rare. It is important to note that the symptoms and severity of each arthritis type can vary significantly among individuals, making it challenging to determine their precise prevalence.
Differentiating OA and RA using blood tests and X-rays
Blood tests and X-rays play crucial roles in distinguishing between OA and RA.
How can blood tests help?
Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies are common blood tests used to diagnose RA. Their presence in the bloodstream can indicate an autoimmune response often associated with RA. Additionally, elevated C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) may suggest inflammation, a characteristic feature of RA.
Unlike RA, blood tests are not typically used to diagnose OA since it is primarily a degenerative condition. However, blood tests may be performed to rule out other forms of inflammatory arthritis or to assess general health.
How can X-rays help?
X-rays are instrumental in assessing the joint damage associated with both OA and RA. In OA, X-rays can reveal joint space narrowing, the formation of osteophytes (bone spurs), and changes in bone density. In RA, X-rays can highlight erosions, joint deformities, and the characteristic pattern of joint involvement, which often affects the small joints of the hands and feet.
Identifying whether you have OA or RA
Diagnosing OA or RA requires a comprehensive evaluation by a healthcare professional, typically a rheumatologist. They will consider various factors, including your medical history, physical examination, imaging studies, and blood test results. Symptoms such as joint pain, stiffness, swelling, and the pattern of joint involvement can provide initial clues.
Key differences between OA and RA
- OA symptoms are often more localised to the affected joint, while RA tends to involve multiple joints on both sides of the body.
- Morning stiffness in OA typically lasts for a short duration, usually less than 30 minutes, whereas in RA, it can persist for longer periods.
- RA symptoms may include systemic effects such as fatigue, weight loss, and fever, which are not commonly associated with OA. I have a blog on 7 less common symptoms of RA.
- Have a look at my blog on the differences between OA and RA.
- For tips on exercising have a look at these blogs. 6 top tips for exercising with osteoarthritis (OA). Exercising with Rheumatoid Arthritis
Conclusion
While it is possible to have OA and RA simultaneously, the coexistence of these conditions is relatively uncommon. Blood tests and X-rays are valuable tools for differentiating between the two. If you think you may have an inflammatory arthritis like RA then early diagnosis is crucial to limit the disease progression a rheumatologist is well paced to help. Please send this to anyone you think may benefit.
Take care, Helen
Helen Manders BSc (Hons) MCSP HCPC
