Rheumatoid arthritis, osteoarthritis. How do the symptoms differ?

Q. I have started having joint pain, and I’m concerned that it might be rheumatoid arthritis. My friend says it’s probably osteoarthritis. How do the symptoms differ?

A. Only a doctor can give you a firm diagnosis. But rheumatoid arthritis (RA) and osteoarthritis (OA) do have some distinctive characteristics that may offer clues.

• Age. RA commonly begins between ages 40 and 50, although it may arise at any age, even the 20s and 30s. OA primarily affects people 60 or older.
• Gender. RA is 2 times more common among women, whereas OA affects men and women more equally.
• Location. RA often begins in the wrists, hands, or fingers (primarily joints at the base of the fingers). RA tends to involve the same joints on both sides of the body. It may also affect the shoulders, elbows, hips, knees, ankles, and toes. OA, on the other hand, primarily affects the weight-bearing joints (knees, hips, spine). But, it may also involve the thumb and knuckles at the middle and tip of the fingers. OA often affects only one side of the body.
• Morning stiffness. With RA, morning stiffness may last several hours, whereas OA-related stiffness typically disappears within 30 minutes.
• Pain pattern. The pain of RA is variable, with periods of mild pain followed by a flare-up. RA-related stiffness may improve as the joints are used. With OA, pain intensifies as the joint is used and typically subsides with rest. OA pain worsens as the day goes on.

If the diagnosis isn’t clear to your doctor following evaluation of your symptoms, x-rays will be taken and blood tests done to help clarify body changes that have occurred.