by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Gout occurs in four stages (asymptomatic, acute, intercritical and chronic) and has the following signs and symptoms:
In the asymptomatic stage, serum uric acid levels rise in the blood, but produce no symptoms. This condition is termed asymptomatic hyperuricemia. There is debate as to the level at which hyperuricemia should be treated. What is known is that the higher the uric acid, the greater likelihood there is of gout occurring.
In the acute stage, attacks of gout take place. The symptoms usually last five to 10 days and consist of:
• sudden attack of pronounced joint pain
• joints feel hot, tender and look dusky red or bruised
This is the first evidence that a patient has gout. While some patients have one attack and do not have any others, the usual case is that this first attack is the beginning of a long string of gouty episodes.
The intercritical stage is a symptom-free interval between gout episodes. Most people have a second attack from six months to two years, while others are symptom-free for five to 10 years. Intercritical periods tend to become shorter and shorter with attacks lasting longer and longer.
Finally, the chronic stage begins with:
• persistently painful joints with large urate deposits in the cartilage, joint capsule, tendons and soft tissues
• skin over the deposits ulcerate and release a white chalky discharge. This discharge consists of masses of uric acid crystals.
• joint stiffness
• restricted motion of affect joint
The chronic stage of gout may be confused with other arthritis conditions such as rheumatoid arthritis. This stage also is known as tophaceous gout.
The diagnosis of gout is based on symptoms, blood tests showing elevated levels of uric acid, and the finding of urate crystals in joint fluid. In chronic gout, x-rays show damage to the cartilage and bones.
Currently, there is no cure for gout, but through proper diet, a healthy lifestyle and medications, gout can be put into remission.
Proper medications can lead to remission with slow disappearance of gout deposits.
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