| Feature | Rheumatoid Arthritis (RA) | Osteoarthritis (OA) |
|---|---|---|
| Onset | Insidious; over weeks to months | Gradual; developing over years |
| Symmetry | Symmetrical polyarthritis | Often asymmetrical, but can be symmetrical in hands |
| Joints Affected | Small joints of hands (MCP, PIP), wrists, feet, knees, ankles; spares DIP | Large weight-bearing joints (knees, hips); hands (DIP, PIP, 1st CMC); spine; spares wrists, elbows, ankles, shoulders |
| Joint Distribution | Multiple joints, especially small joints of hands, feet | Fewer joints, mainly large joints or specific hand joints^1^ 1,^2^ 2 |
| Feature | Rheumatoid Arthritis (RA) | Osteoarthritis (OA) |
|---|---|---|
| Morning Stiffness | >1 hour (often several hours), lessens with activity | <30 minutes, improves quickly with movement, recurs after rest ("gel phenomenon") |
| Stiffness After Inactivity | Yes, marked | Yes, but typically less pronounced |
| Feature | Rheumatoid Arthritis (RA) | Osteoarthritis (OA) |
|---|---|---|
| Timing | Worse in morning and after inactivity; improves with use | Worsens with activity and as day progresses; relieved by rest |
| Pain Quality | Aching, sometimes sharp during flares, with swelling | Dull ache, worsens with weight-bearing/use |
| Feature | Rheumatoid Arthritis (RA) | Osteoarthritis (OA) |
|---|---|---|
| Fever, Malaise, Weight Loss, Fatigue | Common, especially at onset or during flares | Uncommon |
| Other | May have extra-articular manifestations (nodules, anaemia, lung, cardiac) | Not typical; generally local disease |
RA:
OA: