Rheumatoid Arthritis vs. Gout: Which One Is It?
What’s the Difference Between RA and Gout?
At first glance, rheumatoid arthritis (RA) and gout seem almost interchangeable. Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life. However, that’s about where the similarities between the two diseases end.
Click through the slideshow to learn what differentiates RA and gout.
The Disease of Kings
Imagine a laughing, round-bellied king at a feast. In one fist, he clutches a leg of lamb. In the other, he’s sloshing a tankard of beer. In front of him lay roasted meats, overflowing gravy boats, bread and butter, and wheels of cheese. There are cakes, pastries, and sugared nuts.
Now, imagine that same king sitting with his left foot propped up on a pillow. His big toe is terribly swollen and red, the skin stretched over the joint tight as a drum.
He has contracted gout, the “disease of kings.”
What Is Gout?
Gout is an intensely painful type of arthritis that occurs mainly in the joints of the big toe, though it can also attack the heel and ankle. Rarely, it’s been known to attack other joints in the body.
Gout has been associated with an overabundance of rich food and drink since ancient times. But until the 20th century, only the wealthy could afford such luxuries. The Greek philosopher-physician Hippocrates called gout the “arthritis of the rich.”
Galen, a Roman physician, surgeon, and philosopher, was the first to note that gout could be hereditary.
Does Rich Food and Drink Really Cause Gout?
Indirectly, yes. But not always. The body converts purines—which occur naturally in the body and come from the foods we eat—into uric acid. Purine-rich foods include most meats and organ meats, most fish and shellfish, and even some vegetables. Wholegrain breads and cereals contain purine too.
Gout can occur whenever there is too much uric acid in the blood. Uric acid is normally excreted in the urine, but high levels can form sharp crystals in the joints, causing inflammation and intense pain.
What Is Rheumatoid Arthritis?
RA is an autoimmune disease that causes joints all over the body to become inflamed, stiff, painful, and swollen. It causes damage that can be disabling and permanent. According to the American College of Rheumatology, around 1.3 million Americans have RA.
RA is a systemic disease, meaning that it can affect other parts of the body, like organs. This is why people with RA have a higher risk of heart disease than those who don’t.
RA can be treated, but not cured.
What Causes Rheumatoid Arthritis?
RA causes the body to mistakenly attack its own tissues—mainly the synovial capsule that cushions the joints—just as it would foreign invaders like bacteria and viruses.
The medical community doesn’t yet know what causes RA. However, scientists think the disease might be genetic, caused by some trigger in the environment, like a virus, or both.
How Is Rheumatoid Arthritis Treated?
Once RA has been diagnosed, your rheumatologist will choose treatments according to the severity of your disease.
Active, severe RA usually is treated with powerful, biologic disease modifying anti-rheumatic drugs (DMARDs). They work to slow or stop the progression of the disease, which can relieve inflammation and pain.
Mild-to-moderate RA is treated with non-biologic, but still quite effective, DMARDs. Non-steroidal anti-inflammatory drugs (NSAIDs) are also used to treat RA, often in addition to DMARDs.
How Is Gout Treated?
Gout traditionally has been treated by limiting intake of rich foods and alcohol. But modern medicine proves other treatments are far more effective.
Drugs that treat gout include NSAIDs such as indomethacin or naproxen. Corticosteroids, like prednisone, can quickly relieve inflammation and pain. A drug called cholchicine works best when it’s taken within 12 hours of an attack of gout, and it may be given with NSAIDs in small, daily doses to prevent future attacks. Finally, several medicines that block the production of uric acid may be prescribed.
Which Do You Have: RA or Gout?
Making an appointment with your doctor for a diagnosis is the best way to know whether you have RA or gout.
But there are some tendencies that differentiate the diseases. Some defining characteristics include:
- Gout usually occurs in the foot, most commonly at the base of the big toe.
- RA can affect any joint on either side of the body, but most commonly occurs in the small joints of the hands, wrists, and feet.
- Gout is always accompanied by redness, swelling, and intense, agonizing pain.
- A joint affected by RA also may become painful, but won’t always be red or swollen.
- RA pain varies in quality and intensity. Sometimes it’s mild, and sometimes it’s excruciating.
Could You Have Both RA and Gout?
RA and gout may sometimes look and feel the same, but they have different causes. Remember our indulgent king from the beginning of this slideshow? All the rich food and drink he consumed caused excess uric acid in his body, which ultimately lead to gout.
RA is an autoimmune disease, and its cause is still a mystery. Because of these distinct differences, people who have RA can also have gout—and vice versa.
Overeating and obesity aren’t direct causes of gout, but eating like a king is. Excess weight stresses the joints of the hips, knees, ankles, and feet, and can make RA worse. It’s always smart to keep your body weight under control by eating a balanced, healthy diet and limiting your alcohol consumption—and your chances of acquiring gout.
- Fast facts about gout. (2010, July). National Institute of Arthritis and Musculoskeletal Diseases. Retrieved on Dec. 24, 2013 from http://www.niams.nih.gov/Health_Info/Gout/gout_ff.asp
- Gout. (2012, September). American College of Rheumatology. Retrieved on Dec. 24, 2013 from http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/gout.asp
- Nuki, G. and Simpkin, P.A. (2006, April 12). A concise history of gout and hyperuricemia and their treatment. Arthritis Research and Therapy, 8 (Suppl 1): S1. Retrieved on December 21, 2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226106/
- Rheumatoid arthritis patients can get gout, too, Mayo Clinic study finds. (2012, November 5) Mayo Clinic. Retrieved on December 21, 2013 from http://www.mayoclinic.org/news2012-rst/7152.html
- Rheumatoid arthritis. (2012, August). American College of Rheumatology. Retrieved on December 21, 2013 from http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/ra.asp