Coexistence of ochronosis and rheumatoid arthritis - A cause of delay in diagnosis and treatment

Two rheumatic diseases can often coexist despite the interesting fact that gout and rheumatoid arthritis (RA) are infrequently associated. We describe a patient with familial history of alkaytonuria and rheumatoid arthritis w ho developed both diseases. The exact time of onset of the RA was difficult to ascertain. The RA seemed to be rapidly progressive, possibly because of the delayed recognition, overly cautious drug treatment, or additive effec ts of the two diseases. Physicians should keep in mind the possible coexist ence of two joint diseases in patients who are not doing well.