Joints Affected
For many people, gout initially affects the joints in the big toe. Sometime during the course of the disease, it will affect the big toe in about 75% of people. It also can affect the:
Stages
Gout can progress through four stages:
Asymptomatic hyperuricemia In this stage, a person has elevated levels of uric acid in the blood but no other symptoms. A person in this stage does not usually require treatment.
Acute gout/acute gouty arthritis In this stage, hyperuricemia has caused the deposit of uric acid crystals in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which also may be warm and very tender. An acute attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Early attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently.
Interval/intercritical gout This is the period between acute attacks. In this stage, a person does not have any symptoms and has normal joint function.
Chronic tophaceous gout This is the most disabling stage of gout and usually develops over a long period, such as 10 years. In this stage, the disease has caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout don't progress to this stage.
