According to the natural course of gout in three stages, the symptoms are introduced respectively.
Asymptomatic period
There is only fluctuating or persistent hyperuricemia, and gout (arthritis, gout stone, uric acid kidney calculi) has not appeared. 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.
Acute arthritis and intermittent period
It often occurs suddenly at midnight or early morning, and the joint pain is severe, reaching a peak within a few hours, and the affected joints appear 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.
It may be accompanied by hyperuricemia, but the blood uric acid level is normal in some acute attacks;
Uric acid salt crystals were found in joint fluid or tophi;
May be accompanied by fever.
Tophus and chronic arthritis stage
Gout calculus is a characteristic clinical manifestation of gout, usually located in auricle, but also around joints, olecranon, achilles tendon and patellar bursa.
The appearance of tophi is uneven yellow-white vegetation with thin surface, and white powder or paste is discharged after crushing.
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.
Renal pathological symptoms
Patients with gout with a long course of disease may have kidney damage, and their symptoms are very typical, so they need to be vigilant.
Gouty nephropathy: the onset is hidden, and the 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.
Uric acid kidney calculi: From no obvious symptoms to renal colic, hematuria, dysuria, hydronephrosis, pyelonephritis or perinephrosis.
Acute renal failure: a large number of urate crystals block renal tubules, renal pelvis and even ureters, and patients will suddenly appear oliguria or even anuria, which can develop into acute renal failure.
Concurrent syndrome
In addition to the common joint-related symptoms, patients sometimes have other symptoms, including fever (body temperature can reach above 38.5℃), increased heart rate (tachycardia), general malaise, chills (rare) and so on.