1. Asymptomatic period: only fluctuating or persistent hyperuricemia, but gout (arthritis, tophus and uric acid kidney calculi) has not yet occurred. The time from the rise of serum uric acid to the appearance of symptoms can reach several years, and some can be asymptomatic for life.
2. Acute arthritis stage and intermission: Generally, from midnight or early morning, the joints are severely painful, reaching a peak within a few hours, and the affected joints are red, swollen, hot, painful and dysfunctional. The first attack involves a single joint, and 1 metatarsophalangeal joint is the most common. The seizure was self-limited and relieved spontaneously within more than 2 weeks. After the redness subsided, the skin at the affected joints fell off. The serum uric acid level was normal in some acute attacks.
3. Gout stone and chronic arthritis stage: Gout stone is a characteristic clinical manifestation of gout, usually located in auricle, and also common around joints, eagle mouth, achilles tendon and patellar bursa. The appearance of tophi is yellowish-white subcutaneous mass with thin surface, and white powder or paste is discharged after rupture. Chronic arthritis is more common in patients without standardized treatment, and the affected joint is asymmetric, irregular swelling and pain. A large number of tophi are deposited in joints, which can cause joint bone destruction, lead to joint deformity, especially hands and feet, and can cause disability.
It should be noted that gout patients with a long course of disease may have renal damage, and their symptoms are also very typical, often showing gouty nephropathy. The onset of the disease is hidden, and its clinical manifestations are increased nocturia, low specific gravity urine, low molecular weight proteinuria, leukocytosis, mild hematuria and cast. Renal insufficiency, hypertension, edema and anemia may occur in the late stage.