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 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.
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
Review Date: 01/04/2011
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.