Symptoms of gout patients

Gout occurs in many middle-aged and elderly people, because most gout is caused by rheumatism. Rheumatism is an age-related disease caused by living in a humid environment for a long time and not properly protecting the joints. Gout patients not only experience body pain, but some even suffer from joint deformities. Therefore, gout patients should have a proper understanding of what symptoms will appear in their bodies.

First stage asymptomatic hyperuricemia

During this period, the patient's serum uric acid concentration will increase, but no clinical symptoms of arthritis, tophi, or uric acid stones will appear. Some men

Sexually transmitted diseases may develop this condition during puberty and may be related to family history, while female patients more often develop it during menopause. Asymptomatic hyperuricemia may exist throughout one's life, but it may also develop into acute gouty arthritis or kidney stones. Clinically, most asymptomatic hyperuricemia patients will first develop gout symptoms before developing other conditions, but note that about 10% to 40% of patients will first develop kidney stone symptoms.

Second stage acute gouty arthritis

Patients at this stage will experience severe pain in the affected joints. In the early stages of the disease, it is more common to affect a single joint (accounting for 90%), of which about half occur in the metatarsal joints of the foot. As a result, patients are in unbearable pain and cannot put on shoes, so they often come to the clinic wearing slippers. However, as the disease progresses, it is likely to affect multiple joints, and sometimes it may only affect other parts. Common gout-affected areas include the big toe, instep, ankle, heel, knee, wrist, fingers and elbow, but other parts may also be affected. The key point of diagnosis should be to maintain a high degree of vigilance and never assume that pain in other parts of the body is definitely not caused by gout.

Generally speaking, gout patients will begin to experience severe pain and joint inflammation at night, sometimes with fever. This condition often occurs after overeating, especially after a banquet, drinking, taking drugs, trauma or surgery, and sometimes after an ankle sprain, especially when dehydrated. Clinically, there may be no abnormality before the patient goes to bed, but the severe pain caused by a gout attack may wake the patient up from his sleep, and the affected joints will experience severe redness, swelling, heat and pain, which is extremely painful. The symptoms will gradually become more severe, and the chills and tremors will also increase. The most painful moment is like tearing, which is unbearable, and then the symptoms will slowly subside.

Due to local redness, swelling, heat and pain, often accompanied by fever, some patients may also have swollen joints and fluid accumulation, and yellow turbid fluid will appear when the fluid is extracted. Therefore, it is sometimes mistaken for cellulitis or bacterial arthritis and treated with antibiotics. This may last for one or two days or up to two weeks, and then gradually improve.

The third stage of interictal gout

It refers to the period when the patient's symptoms disappear, that is, the patient does not show any symptoms clinically; the interval between attacks varies in length and may last from one or two days to several weeks. About 7% of patients are lucky and their gout will naturally subside and no longer have symptoms, but most patients will relapse within a year. After repeated attacks, the disease tends to be polyarticular, the attacks are more severe, the duration of the attacks is longer, and they are accompanied by fever. But some people will never have an attack again.

Stage IV tophi and chronic gouty arthritis

Patients with tophi and chronic gouty arthritis have a more chronic condition. Uric acid crystals will be deposited in the cartilage, synovial membrane, and soft tissues in the body, forming tophi. The higher the uric acid concentration in the blood and the longer the illness lasts, the more tophi may be deposited, sometimes affecting blood vessels and kidneys, causing serious renal dysfunction.

Failure makes kidney disease more serious and creates a vicious cycle of difficulty in excreting uric acid, resulting in more tophi deposits.

There are many places where tophi are often deposited, including the ears, hands, elbows, Achilles tendons, ankles or toes. Sometimes they can cause local ulcers that are difficult to heal and may even require surgical removal. Severe cases may cause joint deformities or chronic symptoms. Severe foot deformities may cause serious problems for patients in wearing shoes. In addition, the risk of kidney stones increases with the increase of uric acid concentration in serum, and it often causes kidney disease. After renal failure, hemodialysis may be required, which is also one of the main causes of death in gout patients.

In addition, gout is common in patients with obesity, hypertriglyceridemia and hypertension. In obese people, uric acid production increases and excretion decreases, causing hyperuricemia and gout. If these diseases occur simultaneously in clinical practice, it may also cause a situation that is difficult to control, so attention should be paid to evaluating them simultaneously during the examination.