Rheumatoid Arthritis vs. Gout

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by pain and inflammation in more than one joint (polyarthritis) of the hands and feet.

• It is an autoimmune disease, where the immune system of the body attacks healthy cells, resulting in inflammation of the membrane lining the joints (synovial membrane) and eventual damage to joint tissue.
• RA affects other organs, such as the skin, heart, lungs, and eyes, resulting in side effects.

The annual incidence of RA is approximately three cases per 10,000 people worldwide.

Gout is a common form of inflammatory arthritis.

• It is a condition associated with high uric acid levels in the blood.
• These uric acid forms crystals that accumulate around the joints, leading to sudden and severe pain and swelling.

Gout commonly affects the joints of the big toe and is found in joints of the knee, ankle, foot, hand, wrist, and elbow.

Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system attacks its healthy cells and tissues; however, some of the contributory factors to rheumatoid arthritis are:

• Genetic factors
• Some viruses and infectious agents are potential contributory factors
• Sex hormones may play a role in causing RA
• Immune system disorder
• Age between 35 and 50 years
• High-risk ethnic backgrounds, such as Native American
• Women are affected more often than men
• Family history of RA
• Tobacco smoking
• Obesity

A high amount of uric acid in the blood is the main cause of gout. Humans synthesize uric acid from purines found in certain foods and drinks. The uric acid thus formed is eliminated by the kidneys through urine.

When the body produces excess uric acid or when the kidney fails to eliminate the uric acid, the resultant uric acid crystals can concentrate in the joints, resulting in gout. However, many people with higher uric acid do not seem to have uric acid deposition in soft tissues, indicating genetic predisposition.

Gout can affect anyone, especially men and menopausal women. Men are at three times more risk of acquiring gout than women because they have higher uric acid levels most of their lives. Women reach this amount of uric acid levels after menopause.

Some medical conditions that can increase the risk of getting gout include:

• Obesity
• Congestive heart failure
• Diabetes
• Family history of gout
• Hypertension (high blood pressure)
• Kidney disease

Other factors likely to increase a person’s risk of getting gout include:

• Consuming a diet high in animal proteins
• Heavy alcohol drinking
• Being on diuretics
• Some medications

The early occurrence of gout is often due to lifestyle factors that promote high levels of uric acid in the body.

The most common symptoms of rheumatoid arthritis (RA) include morning stiffness and symmetrical symptoms. At times, symptoms worsen, which are called flares, and when a person recuperates from the symptoms, it is called remission.

Some of the other most common symptoms observed in people with RA include:

1. Pain in the joints of hands and feet
2. Pain on motion
3. Swelling and tenderness in one or more joints
4. Restriction in the motion of the affected part
5. Deformity of the affected parts
6. Fever
7. Weakness
8. Fatigue or tiredness
9. Numbness and tingling in the hand or arm
10. Osteoporosis (a condition in which bones become weak and brittle)
11. Muscle weakness
12. Fever that occurs rarely

The most common gout symptom is radiating pain originating in the big toe.

Other symptoms of gout include:

1. Lingering discomfort in the joints that may last from a few days to a few weeks
2. Intense joint pain that is most likely to be severe in the first 4 to 12 hours
3. Fever is mostly seen in gout
4. People with chronic gout develop tiny, hard lumps in the affected joints called tophi

Drugs and lifestyle modifications are the two main treatment options for rheumatoid arthritis and gout.

Drugs commonly used for rheumatoid arthritis include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Ibuprofen, naproxen.
• Disease-modifying anti-rheumatic drugs (DMARDs): Sulfasalazine, leflunomide.
• Immunosuppressants: Methotrexate.
• Corticosteroids: Prednisolone.

Drugs commonly used for gout include:

• Nonsteroidal anti-inflammatory drugs: Ibuprofen, naproxen.
• Colchicine
• Corticosteroids: Prednisone.
• Blocks uric acid production: Allopurinol, febuxostat.
• Enhances uric acid removal: Probenecid.