Judging from these symptoms, gout, rheumatism and rheumatoid arthritis are really difficult for ordinary people to distinguish. However, according to the classification of diseases, gout belongs to metabolic diseases, while rheumatism and rheumatoid arthritis belong to rheumatic immune diseases, so there is still a difference between them.
1. and etiological differentiation
Gout is gouty arthritis caused by the high concentration of uric acid in blood and the precipitation and crystallization of uric acid in acidic environment. Rheumatoid arthritis is currently considered to be closely related to hemolytic streptococcus infection and often causes rheumatic fever. Rheumatoid arthritis is caused by environmental factors, genetic or immune disorders, which activates immune cells in the body, releases a large number of inflammatory factors, and starts the body-specific immune response, thus leading to corresponding arthritis symptoms.
2. Different from clinical manifestations
Gout usually comes on suddenly, and most patients come on suddenly without any warning, especially after midnight. At the onset, the affected joints are severely painful, which may be accompanied by redness and swelling, and most of them involve a single small joint, which is common in the big toe joint, followed by the ankle joint. The symptoms can be naturally relieved in 1-2 weeks. Rheumatoid rheumatoid arthritis has a slow onset, usually when it catches cold or the weather changes. First of all, there may be symptoms such as fatigue, fatigue, loss of appetite or numbness of hands and feet. Most patients have morning stiffness, but gout patients do not have this phenomenon Symmetric arthritis is more common, especially swelling. The more obvious the joint swelling, the heavier the pain.
3. Distinguish from the inspection results
The examination of joint fluid can be used as one of the important indexes to distinguish gouty arthritis from rheumatoid arthritis. Uric acid crystals can be found in joint fluid of gout patients, but rheumatoid factor is negative, and erythrocyte sedimentation rate is generally unpleasant or slightly elevated. Rheumatoid factors can be found in the joint fluid of patients with rheumatoid arthritis, and the erythrocyte sedimentation rate is increased obviously, and uric acid is increased normally or slightly.
4. Different from imaging
Studies have shown that gouty arthritis can be seen with double track sign, punctate strong echo and tophi under ultrasound examination, while rheumatoid arthritis is mostly synovial thickening. In addition, ultrasound also showed that gout mainly invaded the first metatarsophalangeal joint, while rheumatoid arthritis mainly involved the fifth metatarsophalangeal joint. Arthroscopy is also one of the ways to distinguish the two. Under arthroscopy, patients with gouty arthritis mainly show synovial hyperplasia and white crystal deposition, while rheumatoid arthritis mainly shows thickening, obvious synovial sac effusion boundary, uneven thickness and villous structure protrusion.
In short, once there is persistent joint pain, you must go to the rheumatology immunology department for diagnosis after excluding accidents such as trauma and fracture. I would like to remind you in particular that any advertisement promoting drugs such as "treating gout, rheumatism and rheumatoid diseases, and cutting roots in one course of treatment" is a false advertisement. Painkillers and hormones are often added to these drugs, but none of them can fundamentally prevent joint disability. At first, it seemed that the treatment was effective, but once the drug was stopped, the joints became more painful, the joints slowly deformed and the condition became more and more serious. This is really delaying the illness! For example, it takes at least 3 to 5 years to take medicine, and some patients may need to take medicine for life, but as long as the medication is standardized, the progress of the disease can be well controlled and the disease will not spread to other organs and tissues.