The coexistence of rheumatoid arthritis and gout is demonstrated by the presence of a classic rheumatoid nodule and sodium urate crystals in the same person. The diagnosis of rheumatoid arthritis is further substantiated by the presence of a chronic symmetrical polyarthritis and high titers of rheumatoid factor. The diagnosis of gout is further substantiated by the fact that the serum uric acid levels are consistently elevated, by the presence of tophi which contain sodium urate crystals, and by an increased urine excretion of uric acid. Roentgenographic studies of the hands and feet show changes compatible with both diseases.
Owen DS, Toone E, Irby R. Coexistent Rheumatoid Arthritis and Chronic Tophaceous Gout. JAMA. 1966;197(12):953–956. doi:10.1001/jama.1966.03110120059014
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