Gout - Causes

Symptoms

The specific symptoms of gout depend on the stage of the disease. Gout is often divided into four stages:

• Asymptomatic hyperuricemia
• Acute gouty arthritis
• Intercritical gout
• Chronic tophaceous gout

Asymptomatic Hyperuricemia

Asymptomatic means there are no symptoms. Asymptomatic hyperuricemia is considered the first stage of gout. Urate levels slowly increase in the body. This stage may last for 30 years or more.

Note: Hyperuricemia does not inevitably lead to gout. In fact, less than 20% of cases turn out to be full-blown arthritic gout disease.

Symptoms of Acute Gouty Arthritis

Acute gouty arthritis occurs when the first symptoms of gout appear. Sometimes the first signs of gout are brief twinges of pain (petit attacks) in an affected joint. These attacks can precede the actual full-blown condition by several years.

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Symptoms of acute gouty arthritis include:

• Severe pain at and around the joint
  • May feel like "crushing" or a dislocated bone
  • Physical activity and even the weight of bed sheets may be unbearable
  • Usually takes 8 - 12 hours to develop
  • Occurs late at night or early in the morning and may wake you up
• Swelling that may extend beyond the joint
• Warmth over the joint
• Red, shiny, tense skin over the affected area, which may peel after a few days
• Chills and mild fever, loss of appetite, and feelings of ill health

Most often symptoms start in one joint.

Monoarticular Gout. Gout that occurs in one joint is called monoarticular gout. About 60% of all first-time monoarticular gout attacks in middle-aged adults occur in the big toe. This occurrence is known as podagra. Symptoms can also occur in other locations, such as the ankle or knee.

Polyarticular Gout. If more than one joint is affected, the condition is known as polyarticular gout. Multiple joints are affected in only 10 - 20% of first attacks. Older people are more likely to have polyarticular gout. The most frequently affected joints are the foot, ankle, knee, wrist, elbow, and hand. The pain usually occurs in joints on one side of the body and it is usually, although not always, in the lower legs and the feet. People with polyarticular gout are more likely to have a slower onset of pain and a longer delay between attacks. People with polyarticular gout are also more likely to experience low-grade fever, loss of appetite, and a general feeling of poor health.