Coexistence of rheumatoid nodulosis and gout

The case of a 42-year-old white male with a 7-year history of multiple subcutaneous nodules and intermittent episodes of acute arthritis is presented. The patient was found to have monosodium urate crystals on joint aspiration and rheumatoid nodules on biopsy. Our patient, the first reported case of coexistent rheumatoid nodulosis and gout, emphasizes the importance of a thorough evaluation and the need to account for all available clinical and laboratory data. The classification system, differential diagnosis and clinical manifestations of patients presenting with rheumatoid nodules are briefly reviewed.