The Role Of Blood Tests
With no definitive blood test available for RA, doctors instead look for certain antibodies in the blood that would suggest its presence, such as antinuclear antibodies, rheumatoid factor, and anti-cyclic citrullinated peptide antibodies. Your rheumatologist will also order a complete blood count to see if you have anemia, which is common among those with RA.
RA is more difficult to identify than gout because measuring the amount of uric acid in the blood is considered a definitive test for gout, Dr. Portnoff says. However, levels of uric acid are actually lower during a gout flare, so your doctor will want to repeat the test when symptoms subside.
What Types Of Doctors Treat Gout
Rheumatologists traditionally have expertise in diagnosing and treating gout, especially complicated situations. Other specialists such as internists, general practitioners, family medicine doctors, and orthopedists can manage straightforward cases of gout. Nephrologists may treat patients with uric-acid-lowering medications such as allopurinol in order to prevent damage to the kidneys, which can occur with elevated uric acid levels .
Rheumatoid Arthritis Vs Gout
We dont know the exact cause of rheumatoid arthritis, but we know that changes in some of the bodys proteins can set off activation of the immune system, which leads to the release of multiple inflammatory chemicals that cause joint inflammation and damage, with swelling, warmth, tenderness, and discomfort.
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How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
What Are The Signs And Symptoms Of Gout
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remissionweeks, months, or yearswithout symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint may include:
- Pain, usually intense
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Does Arthritis Cause Tendonitis And Vice Versa
In a word, no. Although both involve inflammation arthritis is joint inflammation and tendonitis is inflammation of a tendon having one doesnt directly cause you to develop the other.
That said, these conditions sometimes overlap. People with psoriatic arthritis frequently get enthesitis and tendonitis, says Dr. Huffstutter. In fact, enthesitis is a unique feature of psoriatic arthritis and axial spondyloarthritis .
Do You Have Arthritis Or Tendonitis
Both arthritis and tendonitis can cause pain, swelling, and inflammation. If you feel like thats happening around a joint, it can be hard to know what the problem is. Both arthritis and tendonitis may cause:
- Pain that gets worse when you move the area/joint
- Swelling
- Redness
Because the symptoms can be so similar, doctors may rely heavily on information about where the pain occurs and when the pain first started to determine whether your issue could be arthritis or tendonitis. For example, an achy knee thats been slowly getting worse over the years is more apt to be osteoarthritis, whereas someone who suddenly has pain behind their ankle probably has Achilles tendonitis. Your doctor should also pay attention to risk factors that might make you more vulnerable to one or the other.
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Do Gout And Ra Have The Same Symptoms
Both gout and RA can cause pain and stiffness in multiple joints. But otherwise the two tend to follow different patterns.
Rheumatoid arthritis. This condition usually starts in smaller joints like your hands and feet. Theyâll feel tender, swollen, and warm to the touch. Then it usually moves to other, larger joints like your wrists, elbows, shoulders, ankles, knees, and hips. Itâs rare, but you might also have fatigue and loss of appetite or a fever, though thatâs less likely.
Most people have similar symptoms on both sides of the body. That means if one shoulder hurts, the other one probably does, too.
RA can make your joints feel stiff when you wake up in the morning. The pain may get better with activity over the course of the day.
Gout. Unlike RA, it usually starts with a sudden attack of pain. The pain can be severe. It isnât unusual for a person with gout to feel like their joint is on fire. It might feel like thereâs a hot poker in the joint.
Gout usually affects only one joint. The big toe is a common spot, but gout also can affect ankles, knees, elbows, or wrists.
The affected joint also might look red and swollen. It may be warm to the touch. Sometimes a gout attack can cause a fever.
How To Distinguish Gout From Ra
It can be confusing to tell the difference between RA and gout, so here is some helpful background information to help distinguish between the two:
1. Which joints are involved?
Gout is most common in the big toe, at the joint where the toe meets the foot. Gout is also common at the ankles, midfoot, knees, and elbows. It is usually in later stages of gout when small joints in the hands are involved. RA, however, tends to involve the smaller joints in the hands early on. The pattern of joint involvement is very helpful to physicians in differentiating between gout and RA.
2. What does a gout attack feel like?
If someone thinks they are getting a gout attack, they should look out for the joint’s turning red, which is more common in gout than in RA. While RA is painful, a gout attack is often so intense that the sufferer has great difficulty walking. People with RA can have difficulty walking as well, but the sudden intensity and immediate loss of function is usually more dramatic in gout. The onset of RA pain is more gradual, while the pain from gout generally reaches its peak within 24 hours.
3. What is a uric acid level, and why is it important?
Luckily, gout is an extremely treatable condition, so getting a proper diagnosis and appropriate management is critical. For more information, please visit CreakyJoints.org/goutsurvey.
Important: The views and opinions expressed in this article are those of the author and not Everyday Health.
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Do Gout Medications Have Any Side Effects
- Gout medications are well tolerated by most people. However, like other medications, they have potential side effects.
- Allopurinol is well tolerated by most people, but in some people, it can cause an allergicrash. Very severe rashes rarely can occur after taking allopurinol, and any allergic type rashes that develop while a patient is taking allopurinol are taken seriously.
- Colchicine can cause signs and symptoms such as nausea, diarrhea, and rarely muscle weakness and abnormal blood counts.
- Probenecid is generally well tolerated but should not be used in patients who have uric acid kidney stones, as it can worsen the kidney stones and potentially harm the kidneys in these patients.
Gout Vs Rheumatoid Arthritis What Is The Difference
2 minute read
Gout and rheumatoid arthritis are common bone and joint diseases mostly found in Thai population and worldwide. Since both types of orthopedic problems affect the joints and causing pain and inflammation, gout and rheumatoid arthritis can be generally confused with each another. Knowing the differences of these diseases helps to get accurate diagnosis and receive appropriate treatments in time.
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How Is It Diagnosed
The only way to diagnose gout with certainty is by your doctor finding urate crystals in fluid taken from your joint. Uric acid levels can be measured by blood tests, however these are not always accurate. Uric acid levels may be normal or even lowered during an attack of gout. Blood tests are most useful in ruling out other causes for your symptoms, such as joint infections or other forms of arthritis. X-rays are often normal in the early stages so are not very useful in diagnosing gout.
Diagnosis And Treatment Options For Gout And Rheumatoid Arthritis
Properly diagnosing rheumatoid arthritis involves a slew of tests such as a thorough check of a patients medical history and family history, a physical exam, blood tests to look for biomarkers like rheumatoid factors antibodies commonly seen in rheumatoid arthritis, and imaging tests, like X-ray, ultrasound, and MRI to check for any damage that may have occurred to the joints.
Diagnostic tests for gout include a joint fluid test in which the fluid from the joint is extracted by a needle and tested for uric acid, blood tests to measure uric acid levels, X-ray imaging to rule out other sources of inflammation, ultrasound, and dual energy CT scan to detect urate crystals.
Treatment for rheumatoid arthritis includes the use of a variety of medications, including nonsteroidal anti-inflammatory drugs to relieve pain and reduce inflammation, steroids, disease-modifying antirheumatic drugs, which can help slow down disease progression, and biologic agents that target the immune system as it triggers the inflammation.
Physical therapy and surgery may also be viable treatment options for rheumatoid arthritis in order to increase the range of motion or to replace severely damaged joints.
Gout can also be treated with medications, including NSAIDs and other pain relievers. Some medications can be prescribed to prevent gout complications, including medications to block uric acid and medications to improve uric acid removal.
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Ways Gout And Pseudogout Are Different
Both gout and pseudogout cause sudden joint pain, swelling, and redness, making the two diseases difficult to tell apart. Understanding what makes each condition unique can help when diagnosing, treating, and preventing flare-ups, ultimately minimizing permanent joint damage.
Pseudogout is also known as acute calcium pyrophosphate crystal arthritis . This page describes four ways gout and pseudogout are different.
Half of all gout attacks affect the joint in the big toe. Learn more:Gout Symptoms
Will I Need Surgery For Arthritis
Healthcare providers usually only recommend surgery for certain severe cases of arthritis. These are cases that havent improved with conservative treatments. Surgical options include:
- Fusion: Two or more bones are permanently fused together. Fusion immobilizes a joint and reduces pain caused by movement.
- Joint replacement: A damaged, arthritic joint gets replaced with an artificial joint. Joint replacement preserves joint function and movement. Examples include ankle replacement, hip replacement, knee replacement and shoulder replacement.
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Getting Prompt Treatment For Gout Or Ra
If youve been experiencing symptoms of either condition, you should see your doctor as soon as possible because both can cause significant joint damage if a diagnosis is delayed. However, Dr. Portnoff notes that the pain gout causes is so intense that patients with gout rarely put off seeing a doctor when theyre having an attack.
Theres no cure for gout or RA, but there are several good treatments available for the two conditions. Some pain relief treatments, including NSAIDs and corticosteroids, are recommended to help manage both RA and gout. Because RA is an autoimmune disease, patients may also take disease-modifying immunosuppressant drugs such as methotrexate or other DMARDS or biologics.
Gout, on the other hand, may be treated with the drug colchicine, which relieves pain and helps prevent future attacks. Rheumatologists may also prescribe drugs called xanthine oxidase inhibitors , and sometimes combine those with medications called uricosuric drugs that improve your kidneys ability to remove uric acid from your body. People with gout are also advised to limit foods that promote high levels of uric acid, including red meat, alcohol, and shellfish. However, diet changes alone cannot usually control gout symptoms, and medications are necessary to help prevent complications.
Rheumatoid Arthritis And Gout: Whats The Difference
Arthritis awareness advocates have been busy! May is Arthritis Awareness Month, and today, May 22, is Gout Awareness Day. Like rheumatoid arthritis , gout is known for symptoms such as joint pain, swelling, and stiffness. You may have heard of gout and its symptoms, but do you understand the true impact of this rheumatic disease?
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The Role Of Imaging Tests
Both RA and gout can cause joint erosion, so rheumatologists will order X-rays to look for this. X-rays can also detect the beginnings of tophi, but Dr. Portnoff says theyre not an essential part of the diagnostic process for gout because a patients clinical history, physical exam, and uric acid testing will identify gout.
Gout Vs Rheumatoid Arthritis
Rheumatoid arthritis, commonly abbreviated as RA, is an autoimmune disorder that causes inflammation. While RA primarily affects joints, inflammatory responses may also occur in the skin, heart, lungs, and other organs. Though some hypotheses exist, there is currently no known single cause for RA. Gout is a form of acute arthritis that has a known cause, namely the buildup crystalline uric acid deposits in the blood and joints. These crystals cause an inflammatory response, often in a big toe.
RA and gout can be very painful disorders, but gout tends to be more treatable and has a better prognosis in most cases. To diagnose the presence of either RA or gout, a physician must perform a series of diagnostic imaging tests. To differentiate between gout and pseudogout, fluid may also be drawn from inflamed joints for testing.
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Treating A Gout Attack
Treating an attack of gout doesnt lower your urate levels or stop future attacks. The treatment helps you to manage your symptoms when an attack happens.
The most commonly used drug treatments for attacks of gout are:
Some people will be better suited to NSAIDS, while others will be suited to colchicine. But your preference is also taken into consideration many people with gout quickly learn what works best for them.
In cases where one drug doesnt seem to be working on its own, your doctor might suggest a combination of NSAIDs with either colchicine or steroids.
Non-steroidal anti-inflammatory drugs
Attacks of gout are often treated with NSAID tablets, which can help with pain and reduce some of your inflammation. Ibuprofen, Naproxen and diclofenac are three NSAIDs you could be given.
If youve been prescribed NSAIDs to treat an attack, you should start taking them as soon as you notice signs of one coming on. Your doctor may let you keep a supply so you can start taking them at the first signs of an attack.
The earlier you start treatment, the better.
NSAIDs arent suitable for everyone, so talk to your doctor about them first if you have any other conditions. They can also interact with other drugs, so make sure you talk to a doctor before starting on any new medication.
Colchicine
Colchicine isnt a painkiller, but can be very effective at reducing the inflammation caused by urate crystals.
Colchicine tablets can cause diarrhoea or stomach aches.
Steroids
What Is The Difference Between Gout And Arthritis
It can be confusing to tell the difference between gout and arthritis. Especially if you arent a medical professional. Both conditions cause pain, swelling, and tenderness in the joints. Both are very common among the elderly. It is even possible to have both conditions at the same time! In fact, roughly 2% of arthritis sufferers will experience gout at some point.
Trained medical professionals can treat either condition, but correctly identifying and diagnosing them is key to ensuring proper care. There is one very subtle difference between gout and arthritis. Heres a hint: it has everything to do with their relationship!
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What Can I Do During A Gout Attack
You should see your doctor when you have your first attack of gout. Your doctor will recommend certain medicines to reduce pain and inflammation caused by gout, including:
Always talk to your doctor or pharmacist before you start taking any medicines. You may also need to protect the affected joint. For example, if your big toe is affected you may need to limit the amount of walking you do and create a bed cradle to keep your sheets off your foot when youre in bed.
Diagnostic Tests/lab Tests/lab Values
- Arthrocentesis and synovial fluid analysis: should be performed upon initial presentation..
- Gram stain and culture: to rule out infectious arthritis
- Elevated serum urate levels may support diagnosis but are not sensitive or specific. Levels should be measured on several different occasions and it is possible for levels to be normal during and actute attack. Elevated levels are considered to be greater than 7mg/dL.
- 24 hour urate excretion: normal is 600-900 mg. This may help identify hyper production of uric acid or decreased excretion.
- X-rays: to examine tophi. X-rays are not essential for diagnosis.
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