How to distinguish between gout, rheumatism and rheumatoid arthritis? In clinical practice, we often encounter patients with joint pain accompanied by joint deformity and mobility difficulties. They are always eager to consult their doctors for an accurate diagnosis to solve their pain. However, nowadays, many diseases do not exist independently, but always co-exist. Some diseases are also similar in terms of etiology and symptoms, making it more difficult to diagnose. If you can’t cut into the essence to distinguish the disease it is difficult to confirm the diagnosis, it will be difficult to prescribe the right medicine, and patients will be troubled by the disease for a long time. Therefore, Professor Luo Huazhang, a rheumatologist from Fujian Jinhazang Hospital, believes that it is necessary to distinguish several common joint diseases. The following is an introduction. ”Gout is a hereditary disease with a family history, and its incidence has increased in recent years. It is a metabolic disease caused by disorders of purine metabolism, with inflammatory changes in the joints, connective tissue and kidneys. When uric acid, a purine metabolite, is produced in excess of the kidney’s ability to excrete it, it accumulates in the blood and tissues, forming “gout”. During the acute attack, it often shows joint pain, redness and swelling, and is easily misdiagnosed as “rheumatic” arthritis. 1. The difference between the three gout is almost always seen in men over 40 years old, often showing sudden onset of severe pain at night, mostly with acute arthritis, redness, swelling and pain, peaking in 72 hours, disappearing on its own in a week or two, and reoccurring in several years. When eating a diet containing a lot of purines, such as animal offal, sardines, yeast, tobacco, alcohol, etc., high uric acid accumulation in the blood and tissues is prone to the formation of gout stones, mostly around the toe bones and joints, and also kidney stones, etc. Acute rheumatoid arthritis is an allergic disease related to streptococcal infection. It is often seen in adolescents, mostly after the joints have been affected by rheumatism, and often manifests in large joints, such as knees, ankles, elbows, wrists and other joints with wandering arthritis, and heart muscle and valve damage at the same time, which means that the disease can manifest itself by “licking the joints and biting the heart”. The treatment for both is very different. Gout is treated with anti-purine metabolism and uric acid excretion drugs, such as colchicine, to control symptoms. Rheumatoid arthritis is treated with salicylic acid drugs. As time passes, gout is easily confused with rheumatoid arthritis due to repeated attacks on the joints, not only tissue damage, but also erosion of the joint ends of the bones, plus the deposition of gout stones, which cause chronic inflammation and joint deformities. Rheumatoid arthritis is a chronic systemic autoimmune disease with predominantly joint lesions. It is hereditary, chronic and persistent, with an unclear etiology, and is associated with a combination of factors. Without timely treatment almost all internal organs can be involved: destructive lesions can occur in all joints, causing joints to slowly become deformed, ankylosing, hands in the shape of chicken claws, loss of function, or even paralysis, bone and skeletal muscle atrophy, and often accompanied by extra-articular symptoms, laboratory tests can be seen rheumatoid factor-positive. 2, the three are not difficult to distinguish Gout good diagnosis, measured blood uric acid elevation, feel the gout stone can be determined. The rheumatoid arthritis alone is rarely seen, mostly large arthritis. In the acute phase, there is mostly rheumatic myocarditis, and in the chronic phase, there is “rheumatic heart disease”. The test is positive for Anti-Strand O (ASO). Rheumatoid arthritis is a chronic and persistent disease with significant joint deformity, loss of function, stiffness or paralysis, and a positive rheumatoid factor.