Difference Between Gout and Rheumatism

Gout and rheumatism are very common diseases in daily life, which can

1. Gout and rheumatism

"Gout" is a hereditary disease with a family history, and its incidence has increased in recent years. It is a metabolic disease caused by purine metabolism disorder, characterized by inflammatory changes in joints, connective tissues and kidneys. When the body produces too much uric acid, a product of purine metabolism, which exceeds the kidney's excretion capacity, uric acid accumulates in the blood and tissues, causing "gout". During the acute attack phase, joint pain, redness and swelling are common, and it is easy to misdiagnose as "rheumatic" arthritis. Rheumatism refers to a type of disease characterized by muscle and joint pain. It primarily affects the body's connective tissue and may be caused by damage to the immune system. Traditional Chinese medicine believes that it is caused by external evils such as wind, cold, dampness and heat invading the human body and blocking the meridians.

In modern medicine, it does not refer to a specific disease, but a general term for a class of diseases, including: bursitis, ankylosing spondylitis, adhesive bursitis, osteoarthritis, psoriatic arthritis, rheumatic fever, rheumatoid arthritis/relapsing rheumatism, lupus erythematosus, giant cell arteritis, polymyositis, tenosynovitis, fibromyalgia, inflammatory bowel arthritis, rheumatic heart disease, etc. There are many kinds of herbs used in traditional medicine around the world to treat rheumatism, and modern medicine has different treatments for each of the above diseases.

2. The difference between the two

Although both diseases can cause joint pain, rheumatism mainly causes pain in large joints such as the knees, shoulders, and waist, which are obviously related to weather changes. Clinical tests show high rheumatic indicators and high erythrocyte sedimentation rate. Gout manifests as pain in the big toe, often in the middle of the night, with the foot not touching the ground, and generally redness, swelling, heat and pain. It is not closely related to the climate. Clinical tests show high blood uric acid concentrations. Gout is almost seen in men over 40 years old, often with sudden onset of severe pain at night, mostly with acute arthritis, starting with redness, swelling, and pain, reaching its peak within 72 hours, disappearing on its own in a week or two, and recurring several years later. When eating foods rich in purine, such as animal offal, sardines, yeast, tobacco, and alcohol, high uric acid accumulates in the blood and tissues, easily forming tophi, which are often seen around the toe joints, and can also form kidney stones.

3. Rheumatism

Acute rheumatic arthritis is an allergic disease associated with streptococcal infection. It is more common in adolescents and often occurs after the joints are affected by rheumatism. It often manifests as migratory arthritis in large joints such as the knees, ankles, elbows, wrists, etc., and the myocardium and valves are damaged at the same time. In other words, this disease can manifest as "licking the joints and biting the heart" at the same time. The treatment for both is different.

4. Gout

Gout symptoms are controlled by drugs that inhibit purine metabolism and promote uric acid excretion, such as colchicine. Rheumatoid arthritis is treated with salicylic acid drugs. As time goes by, gout causes repeated attacks in the joints, which not only damages the tissues but also erodes the bone ends. Coupled with the deposition of tophi, the joints become chronically inflamed and deformed, which can easily be confused with rheumatoid arthritis.

Rheumatoid arthritis is a chronic systemic autoimmune disease characterized by joint lesions. It is hereditary and is a chronic disease with unclear etiology, which is related to the combined effects of multiple factors. If not treated in time, almost all internal organs will be affected: destructive lesions may occur in all joints, causing the joints to gradually become deformed and stiff, the hands to become claw-shaped, with loss of function and even paralysis, bone and skeletal muscle atrophy, and are often accompanied by extra-articular symptoms. Laboratory tests may show a positive rheumatoid factor. This disease is an inflammatory, progressive, symmetrical and destructive joint disease, with morning joint stiffness, pain, swelling and dysfunction as the main clinical manifestations. In mild cases, it affects joint function, in severe cases it causes disability, and in very rare severe cases it can cause high-level paraplegia due to damage to the cervical vertebrae, or be life-threatening due to involvement of blood vessels in important organs. Traditional Chinese medicine classifies it as "arthritis", and the disease has a long course and is stubborn. Many scholars believe that rheumatoid arthritis is closer to the "lijie disease" in "Jinkui Yaolue", or called "stubborn arthritis" or "wung arthritis" to distinguish it from other arthritis.

Rheumatoid arthritis rarely occurs alone and is usually a major arthritis. In the acute phase, there is often rheumatic myocarditis, and in the chronic phase, there is often "rheumatic heart disease". The anti-streptavidin-O test (ASO) was positive.