A 65 year old male had episodes of joint redness, swelling, and pain since 1942. Gout was diagnosed in 1955. Intermittently for many years he had episodes of dryness of the mouth, and, since 1963, mild hoarseness and sore throat. Laryngoscopy revealed a whitish spur just beneath the right vocal cord near the cricothyroid joint. The spur was excised; material obtained from it revealed birefringent urate crystals, and histologic examination confirmed it to be a gouty tophus.

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Reaction to stress and stress tolerance resulting from diverse social and economic factors are evaluated by means of various psychologic tests in a group of rheumatoid arthritis and in a control group of nonrheumatoid arthritis patients. The arthritics show a greater incidence of psychophysiologic reaction than the controls. They show greater evidence of contained hostility, presumably because they are unable or unwilling to express feelings of dissatisfaction toward many stressful aspects of their environment. They are also unable to admit to themselves and to others their negative feelings toward their lot in life.Le reaction a stress e le tolerantia pro stress le qua1 resulta ab diverse factores social e economic es evalutate per medio de varie tests psychologic in un gruppo de patientes con arthritis rheumatoide e in un gruppo de controlo de patientes sin arthritis rhenmatoide. Le arthriticos monstra un plus grande incidentia de reactiones psychophysiologic que le patientes de controlo. Illes manifesta plus nette signos de hostilitate restringite, presumitemente proque illes es incapace o non desirose de exprimer sentimentos de dissatisfaction con numerose aspectos stressose de lor ambiente. Illes etiam es incapace de admitter a illes mesme e a alteres lor negative sentimentos relative a lor fato.N 1956 we reportedR the results of projective tests designed to evaluate the I personality structure and unconscious motivation of a group of patients with rheumatoid arthritis as compared with a group of control subjects. Our findings indicated that patients who had rheumatoid arthritis tended either to turn aggression inwardly or to evade and gloss over frustrating situations, rather than to express aggression extrapunitively ; and that early parental conflicts continue to exert their effects unconsciously, resulting in defective personality integration.The present study was undertaken to determine whether there were psychologic differences in reacting to stressful situations resulting from various social and economic factors between rheumatoid arthritis patients and a group of patients hospitalized for diseases other than rheumatoid arthritis. METHODS AND PROCEDURESTwenty-eight patients with peripheral rheumatoid arthritis, two of whom also had rheumatoid spondylitis, and one patient with rheumatoid spondylitis were studied by means of the following instruments: Shipley-Hartford Vocabulary Test, Cornell Index ( N-2 ), selected TAT Cards, a trait-type questionnaire about the male figure drawn by the patient, and a personal data and life events questionnaire. The tests were chi-square, the 275