NURS 6501 Week 8 Assignment; Case Study Analysis - Osteoarthritis & Racial Disparities

2 Week 8 Case Study This case study provides a report of a 74-year-old client who is suffering from osteoarthritis and has been experiencing worsening knee pain over the past few months leading to difficulty moving from a seated position. This case study intends to evaluate the musculoskeletal pathophysiologic processes that lead to this particular patient presentation as well as the racial and ethnic variables that may impact physiological functioning. Pathophysiologic Processes in Osteoarthritis Osteoarthritis involves multiple anatomic and physiological alterations of joint tissues, including cartilage degradation, bone remodeling, and osteophyte formation. This leads to clinical presentation including pain, stiffness, swelling, and limitations in joint function (Allen et. al., 2022). Chondrocytes maintain balance in the production and breakdown of the matrix components; but, in Osteoarthritis the matrix is prominent and leads to overall loss of cartilage (Allen et al., 2022). The data in the case report states that the patient is 220 pounds with a height of 5’8” and is considered obese which likely exacerbates her osteoarthritis. According to King, et al. (2013), subjects with a body mass index greater than 30 were 6.8 times more likely to develop knee Osteoarthritis than normal-weight controls. Weight is considered a modifiable risk factor but only demonstrates modest improvement effects (Lim et al., 2022). Impact of Racial/Ethnic Variables Ethnicity plays a role in the development of Osteoarthritis. According to Reyes & Katz (2021), incidence rates were 22.9% among non-Hispanic white adults, 35.7% in Hispanic adults, and 58.9% in Black adults. There is a disparity in the testing for Osteoarthritis, which includes elements such as socioeconomic status and different reports of pain, leading to conflicting evidence in the literature (Vaughn et al., 2019). 4 References Allen, K., Thoma, L., & Golightly, Y. (2022). Epidemiology of osteoarthritis. Osteoarthritis and Cartilage, 30(2), 184–195. https://doi.org/10.1016/j.joca.2021.04.020 King, L. K., March, L., & Anandacoomarasamy, A. (2013). Obesity & osteoarthritis. The Indian journal of medical research, 138(2), 185–193. Lim, Y. Z., Wong, J., Hussain, S. M., Estee, M. M., Zolio, L., Page, M. J., Harrison, C. L., Wluka, A. E., Wang, Y., & Cicuttini, F. M. (2022). Recommendations for weight management in osteoarthritis: A systematic review of clinical practice guidelines. Osteoarthritis and cartilage open, 4(4), 100298. https://doi.org/10.1016/j.ocarto.2022.100298 Reyes, A. M., & Katz, J. N. (2021). Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management. Rheumatic diseases clinics of North America, 47(1), 21–40. https://doi.org/10.1016/j.rdc.2020.09.006 Vaughn, I., Terry, L., Bartley, J., Schaefer, N., Fillingham, R. (2019). Racial-ethnic differences in Osteoarthritis pain and disability: A meta-analysis. The journal of pain, 20(6), 629- 644. https://doi.org/10.1016/j.jpain.2018.11.012.