Gout is basically a condition related to arthritis that happens when crystals of uric acid amass in your joints, thus it is otherwise known as uric acid crystal-triggered arthritis. The symptoms of gout normally manifests in the joint of the large toe, but it may also show up in the foot, wrist, hand, elbow, ankle and knee. There are some rare occurrences where gout is found on the shoulders, spine or hips. Gout is usually localized, so it does not spread from one joint to another.



Gout occurs when people have high levels of uric acid, a substance that results from the breaking down of body waste products known as purines. In normal quantities, uric acid would just dissolve in one's blood to be filtered by the kidneys and then passed out through urine. However, when the level of uric acid goes too high, crystals form and accumulate in tissues and joints. This causes symptoms such as the inflammation of joint linings, severe pains, redness, tenderness, and localized warmth.

Gout can sometimes be confused with pseudogout, another condition with similar symptoms. However, pseudogout is caused by crystals made of calcium, not uric acid, and thus may require different approaches in treatment.

Usual Gout Symptoms

The typical symptoms for bouts of gout are sudden occurrence of pain, redness, stiffness, warmness, and redness in the affected joint. Some patients develop a slight fever. The pain usually comes from two sources – first, the uric acid crystals that pricks the area when moved, and second, the inflammation of the affected tissues, causing the skin to swell even when it is just touched. This is why even a sheer blanket covering the area may already cause excruciating pain.

The symptoms of gout usually affect the large toe first (around 75 percent of initial gout occurrences), but gout can also manifest in other joints like the spine, fingers, elbow, wrist, knee, instep, heel, and ankles. There are certain cases when gout may affect the smaller toes, especially those that have poor circulation of the blood due to immobilization caused by a previous injury.

Another important symptom of gout is hyperuricemia, or the excessive production of uric acid. Extreme levels of uric acid in the blood are indicators of increased propensity to develop gout. This could further lead to the development of tophi in other areas such as the ear or even in the kidney.

Stages of Gout

The symptoms of gout gradate throughout for different stages. During the first stage, known as asymptomatic, uric levels go beyond normal level, however the symptoms of gout may not yet be that evident. The occurrence of out usually only becomes noticeable during the second stage, known as the acute stage. During the acute stage, symptoms are still mild and can go away within a few days up to some weeks.

After the first attack of the acute stage, the patient may then undergo a symptom-free stage known as the intercritical stage, which could last for some months up to years. The symptoms may recur within six months to about two years from the first attack. Eventually, the patient would reach the chronic stage of gout when attacks become quite frequent, while affecting different joints at the same time. Big tophi may now be located in different joints. This could then lead to kidney damage, kidney stones and hypertension.

How Gout is Diagnosed

Gout symptoms are not enough to confirm the occurrence of the disease as the signs may be confused with other conditions. Medical tests are needed to confirm that the disease is indeed gout. One of the most common tests for gout is measuring uric acid levels. However, this is not really accurate as people can still have gout even if their urate levels are normal, conversely people with high urate levels do not always have gout. Urate level testing are usually performed in conjunction with tests for electrolytes, erythrocyte sedimentaton rates, full blood count, and renal function.

Perhaps the most definitive test for gout is the examination of joint fluid through light microscopy to show the formation of uric acid crystals in polymorphnouclear leukocytes' synovial fluid. However this test is very difficult to perform. An expert technician is needed to distinguish uric acid crystals from other kinds of crystals.

Gout is usually dismissed as a usual condition in life that some people even laugh about it. However gout's symptoms can be quite serious and can even impede on one's normal function. Thus it is important to treat this disease as early as possible.