Ok, weird and rambling post here just to fish for some information from
real people in the real world.

My wife was diagnosed with RA several years ago and has had high levels
of joint damage, pain and all the usual problems.  Due to cost, we
couldn't afford enbrel or humira and methotrexate had little affect.  
The only relief until recently was high doses of ibpuprophen.  She
started plaquenil about a 2 months ago and there is no reason that say
if it is or is not helping yet.

Now we get to the weird part...Everything I read says that gout can
mimic RA.  The RA was diagnosed simply because she had the RA factor in
her blood and a couple of "rat bites" on the bone x-rays of her feet 5
years ago.  However, in some ways the current symptoms seem more like
those listed for gout that is mimicing RA.

First...the RA diagnosis coincided with later stages of
menopause...seems that this also tends to be the case with gout in women.

The RA stated with the big toe joint on one foot and has progressed so
that the toes on both feet are now highly distorted.  Pain was only
"sort of" bilateral...more like one side for a few days and the other to
match a few days later.  It's in all toes and fingertips now

Most pain started in her feet, progressed to her ankles and bottom of
her feet...and of course thumbs, wrists, knees and elbows eventually
came in. Some big joints like shoulders and hips give problems too which
doesn't match gout well.

Pain levels often come and go in short periods...mostly fine all day and
suddenly really bad in an hours time, usually later at night.  Pain may
mostly go away in a joint or area in an hour.  On the other hand, it
might last days.

Recently a hard nodule on one of her fingers appeared to come to the
surface and break...small yellowish crystal seemed to come out.  

Kidney function also showed a slight problem which the doctor atributed
to high ibuprophen use so switched her to tylenol

In hindsight it appears that weeks where she drinks HUGE amounts of
liquids, the pain levels go down.  However it's easy to force yorself to
see what you want on such things rather than reality..for example, she
drinks more when it's hot out and the heat may be the cause of
improvements.

There are a few other things that seem to match gout better than RA like
more meat inthe diet corresponding to more pain the next day but the
infor I can find is mostly non-specific.

Ok, I know I've thrown out a lot of weird stuff.  I have no idea if
there is any chance that gout is complicating the RA, if it's truly only
RA or if there is even a posibility that gout is the predominant problem.

Currently she is seeing only a GP because every rheumatologist she saw
was basically useless..charged 5 times as much and did little that was
any different than the GP...doctor factories..in the door, yup it still
hurts, and out the door.

I guess what I'm looking for here is an opinion as to whether I am just
barking up the stupid tree or whether it's worth beating on the doctor
to look further.  Does or can gout really mimic RA more than just
superficially?  Is there something she can do at home to give
improvement if to is related to gout to help convince a doctor to look
further? (currently trying to get her to drink a ton of water for a few
days).

am I being a dumb-a.s to even think it is possible gout might be the
culprit in addition to or instead of RA?

Thanks for the opinions...I feel like one of those people who searches
for diseases and then makes the symptoms match...however, she's losing
joints fast and it's worth checking into long-shots.

Koz