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December 8, 1978

Rheumatoid Arthritis and Chronic Gouty Arthropathy

Author Affiliations

From the Division of Medicine, Section of Rheumatology, Albert Einstein Medical Center, Northern Division, Philadelphia.

JAMA. 1978;240(24):2658-2659. doi:10.1001/jama.1978.03290240058028

AN AXIOM of rheumatology holds that gout and rheumatoid arthritis rarely occur together. Indeed, only three histologically confirmed cases of such an association have been reported in America.1-3 Our case history documents both chronic tophaceous gouty arthropathy and classical rheumatoid arthritis in the same patient.

Report of a Case  A 39-year-old man was referred to the Arthritis Center in September 1976 for evaluation of his chronic polyarthritis. He had noted the gradual onset of arthritic symptoms in 1961 when pain, swelling, and stiffness developed in both ankles. This was followed by intermittent similar involvement of his right knee and both wrists. From 1965 to 1976, chronic symmetrical arthritis gradually developed, with progressive deformities of his right ankle and both wrists. This was diagnosed as rheumatoid arthritis. Chrysotherapy was begun in 1971. There had been no symptoms suggestive of podagra or of acute arthritis involving any other joints.During the