The Two Types Of Arthritis – At first glance, it seems that uric acid and rheumatoid arthritis are not so different. Both cause pain, swelling, and joint stiffness that can limit your range of motion. However, the reason is different. RA is an autoimmune disease, which means the body’s own immune system attacks the joints, while gout pain is caused by increased levels of uric acid in the blood. But despite some similarities in symptoms, rheumatologists usually have little trouble distinguishing the two conditions.
“Cases of gout are often unambiguous because the flash of pain that patients experience during a flare is so dramatic,” says Dr. Kelly A. Portnoff, MD, a rheumatologist at The Portland Clinic in Portland, Oregon. “It feels like a hot poker in their pond. But if you have RA, the pain creeps up on you.
The Two Types Of Arthritis
The patient’s age also gives clues. Although rheumatoid arthritis can affect almost anyone, it most often appears in women of childbearing age. Gout usually appears in one of two stages of life: late 20s/early 30s and in the 70s and 80s.
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“When uric acid attacks earlier, it is often due to lifestyle factors that promote high uric acid levels, such as a diet high in meat and excessive alcohol consumption,” says Dr. Portnoff. When gout occurs later in life, it is more likely to be the result of kidney damage or health conditions that increase the risk of gout, such as high blood pressure, diabetes, and heart disease.
Migrating pain: uric acid usually affects the big toe, but it can also occur in the ankles, knees, elbows, wrists and fingers. Symptoms are rarely symmetrical, and their location changes depending on the exacerbation. For example, an attack on the left big toe can be followed by an attack on the right big toe, and the next gout attack can attack one of the knees or wrists.
Fever: People with RA sometimes experience fever, but it is more common in people with gout, says Dr. Portnoff: fever.
Tophi: Over time, people with chronic gout can develop small, hard lumps in the affected joints. These lumps, called tophi, are clusters of uric acid crystals. It can also form in the kidneys and lead to kidney stones.
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Symmetrical symptoms: in RA, joint pain usually affects both sides of the body. Symptoms usually begin in the small joints of the hands and feet; As the disease progresses, there may be pain in the wrists, knees, ankles, elbows, hips and shoulders.
Morning stiffness: RA pain is usually worst in the morning, resulting in a period of stiffness that can last an hour or more. Movement helps relieve RA symptoms, so people generally feel better later in the day when they engage in more activities.
Because there is no definitive blood test available for RA, doctors instead look for certain antibodies in the blood that will suggest their presence, such as antinuclear antibodies, rheumatoid factor, and anti-cyclic citrullinated peptide (anti-CCP) antibodies. Your rheumatologist will also order a complete blood count to see if you have anemia, which is common in people with RA.
“RA is more difficult to identify than gout because measuring the amount of uric acid in the blood is considered the ultimate test for gout,” says Dr. Portnoff. However, uric acid levels are actually lower during a gout flare, so your doctor will want to repeat the test if your symptoms subside.
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Both RA and gout can cause joint erosion, so rheumatologists will order an X-ray to check for this. X-rays can also detect the beginning of gout, but Dr. Portnoff says they are not an important part of the diagnostic process of gout because the patient’s clinical history, physical exam, and uric acid testing will determine gout.
If you experience symptoms of either condition, you should see your doctor as soon as possible, because both can cause significant joint damage if the diagnosis is delayed. However, Dr. Portnoff notes that the pain caused by gout is so intense that gout patients rarely delay seeing a doctor if they have an attack. (It’s important to take your gout medication regularly, even between attacks.)
There is no cure for gout or RA, but there are several good treatments for these two conditions. Several pain relievers, including NSAIDs and corticosteroids, are recommended for the treatment of RA and gout. Because RA is an autoimmune disease, patients may also take disease-modifying immunosuppressants such as methotrexate or other DMARDs (disease-modifying anti-rheumatic drugs) or biologics.
Gout, on the other hand, can be treated with colchicine, which relieves pain and helps prevent future attacks. Rheumatologists can also prescribe medications called xanthine oxidase inhibitors (which reduce the amount of uric acid produced by the body) and sometimes combine them with medications called diuretics, which increase the kidney’s ability to remove uric acid from the body. People with gout are also advised to limit foods that promote high uric acid levels, including red meat, alcohol, and shellfish. However, dietary changes alone usually cannot control gout symptoms, and medication is needed to prevent complications.
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Is a digital community for millions of arthritis patients and their caregivers around the world who are looking for education, support, advocacy and patient-centered research. We represent patients through our popular social media channels, our website and our 50-Country Network, which includes nearly 1,500 trained patient volunteers, caregivers and health advocates. Learn how the symptoms, diagnosis and treatment of RA and OA differ – and why this information can help you work with your doctor for the best treatment.
Rheumatoid arthritis (RA) and osteoarthritis (OA) can cause significant pain and joint problems, but they are two different types of arthritis.
RA is an autoimmune disease that occurs when the immune system fails and starts attacking healthy tissue, especially the synovium (joint lining). The same inflammation that affects the joints can also damage organs, including the eyes, skin, heart, and lungs.
Unlike RA, OA is not an autoimmune disease. You can get it when articular cartilage — the smooth white tissue at the ends of bones where they meet to form joints — breaks down. This failure is the result of daily wear.
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“As I like to tell my patients, OA is a wear-and-tear type of arthritis, similar to a tire that wears out with use, while RA is an autoimmune disease where it tries to solve the problem thoroughly,” he said. dr. Jiha Lee, a rheumatologist at the University of Michigan Health.
This is the main difference between RA and OA. But many other differences can help your doctor determine your type of arthritis and treatment options.
According to a 2020 report in Preventive Medicine Reports, osteoarthritis affects more than 30 million American adults, making it one of the most common rheumatic diseases. On the other hand, RA is the most common systemic (whole body) autoimmune disease, affecting approximately 0.5% to 1.0% of the American population.
Both RA and OA cause inflammation in the joints, but there is more inflammation in RA. In recent years, researchers have discovered that inflammation can occur in OA leading to radiological progression and pain, but they are uncertain about the role of inflammation and whether it is a cause or a consequence of osteoarthritis.
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OA and RA can share symptoms, but RA often affects multiple joints symmetrically (on both sides of the body). OA will only affect a few joints on one side of the body. RA also causes flu-like symptoms such as fever and malaise (generally feeling unwell).
RA progression is more difficult to predict. Osteoarthritis is more predictable because the symptoms are limited to the affected joints. However, OA can still be a debilitating condition.
“Both conditions cause a lot of disability and loss of function. In the case of RA, we have treatments that can slow down the disease process and achieve remission. With OA, there is a progression over time that can lead to surgery in the future,” said Dr. Lee.
The goals of treatment for RA and OA are the same – to maintain joint function, reduce pain, and minimize the potential for joint damage. But this condition needs to be treated and managed in other ways, which makes correct diagnosis critical.
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For RA, diagnosis involves a medical history, physical examination, blood tests, and imaging studies. Your medical history with RA is helpful because the disease is genetic.
Diagnosis of osteoarthritis usually involves a medical history, physical examination, and imaging tests. A blood test can be done to rule out RA and other types of autoimmune arthritis.
With such an overlapping diagnosis, RA is sometimes confused with OA – “this is a common occurrence, especially when the patient is older,” said Dr. Lee. This is especially common in erosive osteoarthritis. Sometimes mistakes can be made, causing delays in diagnosis and treatment. Erosive osteoarthritis is a rarer and more severe form of osteoarthritis that involves bone erosion and cartilage destruction in the fingers.
According to Dr. Lee, x-ray, ultrasound,