To table 10 it should be added that gout, in fact, is a metabolic disease with impaired purine metabolism, involving nucleic acids of the nuclear substance of cells and the formation of excess uric acid and its salts circulating in the blood and deposited in the tissues.
Despite the fact that gout is an exchangeable disease, it proceeds with a violent inflammatory reaction, often masquerading as an infectious process, which leads to erroneous diagnoses: phlegmon of joints, osteomyelitis, tuberculosis, rheumatoid arthritis, etc. With a chronic course, gout leads to disfiguring
joint deformities, which complements the similarity with rheumatoid arthritis. In this case, there are pronounced acute phase indicators of inflammation: CRP, ESR acceleration , and etc. As well as rheumatoid arthritis, gout often crust Paet death from uremia due to renal damage…
However, the differences between gout and rheumatoid arthritis are so contrasting that errors in the differential diagnosis between them should not occur. They say who saw gout at least once, he can not recognize it a second time.
First of all, the dramatic severity of gout attacks is striking, when patients can indicate not only the day, but also the hour of onset of the disease. At the same time, the phalangeal and metacarpal-phalangeal joints of the 1st finger are necessarily involved in the process with my unbearable pain and local signs of vigilance resembling phlegmon.
In the area of the joints and along the edge of the auricles, characteristic gouty tophi are formed, filled with uric acid crystals, which are released to the outside during the disintegration of tofus.
Biochemical detection of uric acid in tophus or its elevated content in the blood confirm the diagnosis of gout. Rheumatoid factor for gout was not detected. Significant differences are noted in radiographic examination of the joints with the destruction of cartilage in RA and bone substance of the epiphyses in gout. Kidney damage in RA and gout are different. In the first case, amyloidosis and glomerulonephritis develops, in the second, urolithiasis and pyelonephritis (as a result of acid diathesis).