Assumption #1. Gout does not occur in patients with rheumatoid arthritis.
In another one of those large longitudinal studies from the Mayo Clinic, during nearly 10,000 patient-years of followup among people with rheumatoid arthritis (RA), the 25-year cumulative incidence of gout diagnosed by clinical criteria was 5.3%, arising most commonly in the great toe. Monosodium urate crystals were documented in nearly half of these patients, all of whom were diagnosed with RA before gout developed. This is a lower rate of gout occurrence than in the general population, although the risk factors are similar: male gender, obesity, and older age.