The term “rheumatism” is often used to refer to rheumatoid arthritis among patients who come to the rheumatology department. Although rheumatoid arthritis and gout belong to the same category of rheumatic diseases, the pathogenesis, clinical manifestations, diagnosis and treatment of the two are quite different. First, the onset of rheumatoid arthritis is related to the abnormal function of the body’s immune system attacking its own normal synovial tissue, while gout is due to abnormalities in human uric acid metabolism, long-term high blood uric acid levels lead to the precipitation of urate crystals deposited in joints, cartilage, muscle and other parts. Secondly, rheumatoid arthritis is common in middle-aged and elderly female patients, with symmetrical multi-joint swelling and pain in the fingers, toes, wrists, elbows, ankles, knees, etc. Gout is highly prevalent in middle-aged and elderly male patients, with unilateral toe joint redness, swelling and heat pain, and generally rare simultaneous onset of multiple joints. Third, rheumatoid arthritis blood rheumatoid factor positive, blood uric acid levels are generally normal; gout patients with high blood uric acid levels, rheumatoid factor negative. Fourth, rheumatoid arthritis treatment requires the use of glucocorticoids and immunosuppressants, while gout requires the use of anti-inflammatory painkillers and uric acid-lowering drugs. It can be seen that rheumatoid arthritis and gout are two identical diseases with their own diagnostic criteria, but they can also be seen together in clinical practice.