Rheumatoid arthritis vs.

gout: Symptoms and

causes
By Rachel Nall | Last reviewed Tue 23 Oct 2018

Reviewed by Alana Biggers, MD, MPH

Table of contents

RA vs. gout

Who is affected?

Symptoms and long-term effects

Causes and risk factors

Diagnosis

Treatments

Outlook

Rheumatoid arthritis and gout are two types of arthritis or arthritides.

Both types affect the joints, causing pain and inflammation.

Rheumatoid arthritis (RA) and gout can be confused with each another when gout causes
nodules to form in the hands or feet as they can in RA.

People can have both RA and gout, although the causes and treatments of each are
different. An estimated 2 percent of people with RA will also experience gout.

Doctors can treat both conditions, but it is important that people receive the correct
diagnosis to determine the most appropriate treatment.
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RA vs. gout
RA is an autoimmune inflammatory
condition.

It occurs when the body's immune system

mistakenly attacks healthy cells in the
synovial tissues or linings of the joints.

This reaction causes inflammation, pain, and

swelling. It usually occurs in the hands,
Rheumatoid arthritis commonly affects the hands and knees.
wrists, ankles, and knees on both sides of
the body.

Over time, repeated bouts of swelling can

lead to joint damage.

Gout is also an inflammatory disorder, but it is not an autoimmune condition. Instead, a

person with gout develops high levels of uric acid in their blood.

Uric acid is present in foods and drinks, and taking certain medications can also increase
the amount of uric acid in the body.

These uric acid crystals can deposit in the synovial tissues, especially in the hands, feet,
and elbows.

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Who do RA and gout affect?

RA affects more women than men. An estimated 1.5 million people in the United States
have RA, and the condition affects almost three times as many women as men.

On the other hand, gout affects more men than women. An estimated 4 percent of
American adults, or about 6 million men and 2 million women, have gout.

Symptoms and long-term effects

Some symptoms of RA and gout are different, including the areas affected and the long-
term effects.

Doctors do not associate gout with causing the range of long-term problems that RA can,
such as heart and respiratory diseases.

Symptoms of RA

A person with RA will experience bouts when their symptoms are worse and periods
where symptoms reduce or disappear. Doctors call these flares and remissions.

During the early flares ofA DRA, symptoms may include:

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fatigue
 fever

pain, aching, or stiffness in the joints

stiffness in more than one joint

pain and stiffness on both sides of the body, such as both wrists or ankles

weakness

weight loss

RA can lead to progressive and long-term complications, even with medicines. Long-term
effects of RA include:

bone density loss

damage to the joints

changes in the appearance and mobility of hands and feet

premature heart disease

scarring and inflammation in the eyes

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Symptoms of gout

Similarly to an RA flare, people may get periodic attacks of gout that come and go. People
experience an attack of gout or acute gout when excess uric acid crystals deposit in the
joints.
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Gout often occurs after a trigger, such as drinking too much alcohol, which increases the
quantity of uric acid crystals in the body.
Symptoms of gout in the joints may include:

reduced range of motion

swelling

tenderness

warmth

The joint most commonly affected by gout is the big toe. Gout does not usually affect
multiple joints in the earlier stages, during an acute flare-up.

People can also experience gout in their ankles, fingers, elbows, or wrists.

Gout does not usually cause the same autoimmune reactions as RA, such as fever and
brain fog.

Causes and risk factors

RA is caused by problems with a person's
immune system, though doctors do not Drinking alcohol regularly can increase the risk of developing
gout.
know why this occurs in some people and
not others.

Individuals with the following risk factors are

more likely to experience RA than others:

Age: According to the Centers for Disease Control and Prevention, the onset of
RA typically occurs in adults in their 60s.

Sex: Women experience RA more often than men.

Genetics: A family history of RA makes people more likely to experience the

condition.
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Body mass: People with obesity are more likely to experience RA.
 Smoking: Those who smoke or experienced exposure to cigarette smoke in the
womb are more likely to have RA.

Gout occurs when a person's body builds up excess amounts of uric acid. Some people
naturally produce excess uric acid, which can make gout more likely.

People with the following risk factors are more likely to experience uric acid build-up, or
gout, such as:

Age and sex: Men are more likely to have gout when they are under age 60.
After that time, women may experience gout as much as men.

Genetics: People with a family history of gout are more likely to experience the
condition.

Health conditions: A history of certain health conditions, such as high cholesterol,

high blood pressure, diabetes, and heart disease, make gout more likely.

Medications: Taking medications, such as diuretics or "water pills" or medicines

used to treat RA or psoriasis, can increase the risk of gout.

Diet: A diet high in red meat, shellfish, alcohol, and sodas can all increase the
likelihood a person will have gout.

Body mass: People who are overweight are at a higher risk of developing gout.

In severe cases, people can experience chronic gout. This involves frequent gout attacks
and joint damage. With treatment, a person can often manage their gout symptoms before
the chronic effects occur.

Diagnosis
To diagnose RA or gout, a doctor will start by taking a person's medical history and
symptoms. They will ask about their diet, any medications they take, and any other
chronic conditions.

A doctor will also conduct

A D VaE Rphysical
T I S E M E N T exam and consider where a person is experiencing

their symptoms. For example, if a person has gout, they will likely have pain in their big
toe.
A doctor will also organize blood testing. If a person has gout, their uric acid levels will
usually be high. A doctor may order other blood tests to check for properties that are also
frequently high in people with RA, including:

anti-cyclic citrullinated peptide

C-reactive protein

erythrocyte sedimentation rate

rheumatoid factor

Doctors may order imaging tests, such as X-ray and MRI scans, to check for possible
damage to soft tissue or bone.

Imaging tests can detect a buildup of uric acid crystals around the joints or if there are
signs of inflammation around the joints that could resemble RA.

A doctor may use a needle to remove fluid from the swollen joint to test for the presence
of uric acid crystals that may indicate gout.

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Treatments
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Correctly identifying RA versus gout is
important because the treatments are Prescription medications are the usual treatments for RA and
gout.
different.

Treatments for gout include:

Taking medications to reduce the amount of uric acid in the body, such as
colchicine, which may work for an acute attack or general prevention.

Taking medications, such as allopurinol, to block the production of uric acid, or to

encourage the removal of uric acid, such as probenecid. These medicines can
help to prevent attacks.

Taking medications to reduce acute gout inflammation, such as nonsteroidal anti-

inflammatory drugs (NSAIDs).

Embarking on dietary changes, such as avoiding foods and drinks known to

cause gout.

People may be able to slow or halt the progression of RA by taking medications that
reduce inflammation in the body and slow the immune response that contributes to the
inflammation.

RA treatments include:

disease-modifying antirheumatic drugs (DMARDs)

biologic response modifiers (biologicals)

eating an anti-inflammatory diet

A person may need to try several different medications before finding the ones that best
manage their condition.

Lifestyle changes, such as losing weight and stopping smoking, may also help to slow the
progression of RA.

Outlook
RA and gout are both forms of arthritis or arthritides, but they cause different symptoms
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and have different long-term effects and treatments.

Gout is usually related to lifestyle, such as diet, and inflammation frequently occurs in the
big toe. In contrast, RA usually causes pain in the hands, wrists, and ankles.

Each condition causes changes in the blood that a doctor can detect. Accurate diagnosis
and treatment are vital because each condition has different underlying causes and
treatments.

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Additional information

Article last reviewed by Tue 23 October 2018.

Visit our Rheumatoid Arthritis category page for the latest news on this subject, or sign up to our
newsletter to receive the latest updates on Rheumatoid Arthritis.

All references are available in the References tab.

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References
Citations

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