Wrist pain, if the most important test to determine gout is the presence of uric acid, multispectral CT or ultrasound, and the presence of urate crystals at the wrist. Wrist pain if bilateral, it is best to identify rheumatoid arthritis. General gout pain occurs in the lower extremity joints more, the wrist joints are not too much, for if the disease is longer, had repeated attacks of gout pain, this time again unilateral wrist pain, redness, swelling, heat, pain manifestations, acute attacks do also need to consider gout. Rheumatoid joint examination needs to improve the rheumatoid factor, anti-cyclic citrullinated peptide antibody, blood sedimentation, C-reactive protein and so on. Generally, rheumatoid pain is symmetrical, small joint pain, including finger joints, wrist joints, shoulder joints, knee joints, metatarsophalangeal joints and so on. Of course there is a combination of gout and rheumatoid joints, but it is also relatively rare. The pain of gout usually gets better on its own within two weeks, and the pain of rheumatoid is usually persistent swelling and pain for a longer period of time.