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 alkaptonuria and rheumatoid arthritis who 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 effects of the two diseases. Physicians should keep in mind the possible coexistence of two joint diseases in patients who are not doing well.