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Difference Between Gout and Rheumatoid Arthritis

Gout is the disorder where too much uric acid occurs in the joints. Rheumatoid arthritis is the disorder where the immune system attacks the joints.


What is Gout?


Gout is a condition of the joints that results when too much uric acid is deposited. It is mostly seen in joints of the big toes, but can occur in the elbow, wrist or ankle joint as well.


The most notable symptoms are red, swollen joints that are painful. The most commonly affected joint is the big toe but many other joints, including the ankles and wrists, can be impacted by gout


A physical exam may suggest gout but this is best confirmed by taking a sample of fluid from the synovial cavity of the affected joint. The fluid will have uric acid present if gout is the cause of the problem. Sometimes ultrasound and X-ray can show lesions on the bone that suggest gout.


Gout is caused mostly because the kidneys are not functioning properly and getting rid of the uric acid. Some medical problems can also cause too much uric acid. For instance, some types of blood cancer and hemolytic anemia can cause the condition.

Risk factors:

Risk factors for developing the condition include having kidney disease, being diabetic, being hypertensive or having high blood cholesterol levels.  Further risk factors seem to be women who start menopause early and people who are very overweight.


There is a risk of complications such as the formation of painful kidney stones and in addition, there may be the formation of tophi under the skin. The tophi are deposits of the uric acid crystals.


Maintaining a healthy weight and avoiding foods that contain high levels of purine can help to prevent gout from developing. Regular exercise and watching your diet can help especially if you are overweight and have diabetes.


Gout can be treated with colchicine and corticosteroid medications. Anti-inflammatory medication can help with the pain and inflammation of the joints. In some cases, the joint can be splinted which can be helpful.


What is Rheumatoid Arthritis?


Rheumatoid arthritis is a disease classified as an autoimmune disorder in which the joints of the body are affected.


The symptoms include stiff and sore joints that feel worse in the morning or after a person has done a lot of exercise. Joints are often affected on both sides of the body, and they may be swollen. The person may also feel tired and have a slight fever. The joints most often affected by rheumatoid arthritis are those of the arms, legs, hands, and feet. Another typical symptom is that the same joint on both sides of the body is impacted, so for instance, the left and right hands.


The diagnosis is based on a test looking for the presence of antibodies, in particular, anti-cyclic citrullinated peptide (anti-CCP) antibodies. These tend to be elevated in people who have rheumatoid arthritis. This test can be used along with the physical exam to diagnose the condition.


The exact cause of the condition is not known for certain, but it is believed to be a problem with the immune system attacking the joints. Genetic and environmental factors may both play a role in causing the disorder.

Risk factors:

Women between ages 35 and 50, who are also overweight, are at highest risk for developing rheumatoid arthritis. Individuals with certain genetic traits related to a component of the immune system, also seem to be at an increased risk, as well as women who have smoked and never given birth.


This condition also seems to increase the risk of cardiovascular disease. Besides heart disease, another complication is diabetes and obesity due to an individual becoming less mobile due to the joint discomfort. The patient is also more likely to catch an infection if taking immunosuppressant medications since these weaken the immune system.


Not much can be done to prevent getting rheumatoid arthritis although maintaining a healthy weight may help.  Exercise and a healthy diet may be helpful in preventing weight gain and thus may possibly help to reduce the chance of getting rheumatoid arthritis.


Treatment of the condition relies on anti-inflammatory medications, joint splints, heat therapy and sometimes certain types of exercises to help with the joint stiffness. Methotrexate is a medicine that can be used which suppresses the immune system and other drugs such as hydroxychloroquine can help. Corticosteroids given as oral medication or as injections may also be helpful in controlling the symptoms.


Difference between Gout and Rheumatoid Arthritis


In gout, the joints are impacted by the deposition of uric acid crystals. In rheumatoid arthritis, the joints are attacked by the cells of the immune system.

Symmetric joints

Joints on both sides of the body (symmetric) are not commonly affected by gout. Joints that are symmetric are often affected by rheumatoid arthritis.

Morning stiffness

Patients with gout do not typically have morning stiffness of the joints. Patients with rheumatoid arthritis often show morning stiffness of the joints.


Gout is diagnosed when the doctor finds uric acid crystals in the fluid of the synovial cavity. Rheumatoid arthritis is diagnosed when the doctor finds the presence of anti-CCP antibodies in the bloodstream.


Gout is caused when there is too much uric acid in the body. Rheumatoid arthritis is caused by an autoimmune response of the body.

Risk factors

The risk factors for developing gout include having kidney disease, diabetes, hypertension, and being obese. The risk factors for developing rheumatoid arthritis include being a female between ages 35 and 50 and being overweight.


Possible complications with gout include the development of tophi and kidney stones. Possible complications with rheumatoid arthritis include weight gain, diabetes, and heart disease.


Colchicine, anti-inflammatory medicine, and corticosteroids are used to treat gout. Methotrexate, hydroxychloroquine, corticosteroids, heat therapy, and movement exercises are used to treat rheumatoid arthritis.

Table comparing Gout and Rheumatoid Arthritis


Summary of Gout Vs. Rheumatoid Arthritis

  • Both gout and rheumatoid arthritis cause problems with the joints including pain and swelling.
  • Gout happens when there is too much uric acid in the body causing it to be deposited in the joints.
  • Rheumatoid arthritis seems to occur because the immune system attacks the joints of the body.
  • Both conditions can be treated with medications.


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References :

[0]Edwards, N. Lawrence. “Gout”.  Merckmanuals. Merck & Co., 2018, https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/crystal-induced-arthritides/gout

[1]Kontzias, Apostolos. “Rheumatoid arthritis (RA)”. Merckmanuals. Merck & Co., 2018, https://www.msdmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/joint-disorders/rheumatoid-arthritis-ra?query=rheumatoid%20arthritis

[2]Singh, Jasvinder A., Supriya G. Reddy, and Joseph Kundukulam. "Risk factors for gout and prevention: a systematic review of the literature." Current opinion in rheumatology 23.2 (2011): 192.

[3]Image credit: https://commons.wikimedia.org/wiki/File:Rheumatoid_Arthritis.JPG

[4]Image credit: https://pixabay.com/photos/feet-gout-pain-foot-human-anomaly-174216/

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