Common symptoms of gout include sudden joint pain and swelling. This inflammatory arthritis predominantly affects men and typically presents as acute joint pain, most often in the joints of the feet.
This article was written under the professional guidance of Nguyen Thi Oanh, MSc, MD, in the Rheumatology Department of General Internal Medicine – Vinmec Times City International General Hospital.
1. What are the symptoms of gout?
Acute gout symptoms usually affect joints in the lower part of the body, especially the big toe, knee, metatarsophalangeal joints, and other joints.
These symptoms include sudden severe pain, swelling, and inflammation in the ankle and big toe joints. Besides the big toe, other common sites where symptoms may appear include the dorsum of the foot, ankle, wrist, fingers, and knees.
In the early stage of gout, typically only one or two joints are affected. Although crystal arthropathies in general, and gout in particular, usually involve a single joint, acute attacks affecting multiple joints are not uncommon.
Often, multiple joints within the same limb are involved. For example, gout symptoms may begin in the big toe and then spread to other joints such as the middle toes and ankle.
Gout attacks often occur suddenly and cause peak pain within 8 to 12 hours. The affected joints usually become red, warm, and extremely sensitive; even light contact with materials such as bedsheets can cause pain and discomfort.
Approximately 10% of patients initially present with polyarticular gout symptoms. In elderly women, especially those using thiazide diuretics, polyarticular inflammation may be the first manifestation of gout.
Early-stage gout symptoms often do not require treatment as they typically resolve within about two weeks. Patients with a history of intermittent arthritis, with joints returning to normal between attacks, demonstrate a characteristic pattern of crystal deposition disease, indicative of early-stage gouty arthritis.
If untreated, gout symptoms worsen over time, with attacks becoming more frequent, lasting longer, and affecting more joints in both the upper and lower limbs. Eventually, gout may progress to chronic polyarticular arthritis, sometims symmetric and resembling rheumatoid arthritis.
2. Clinical symptoms of gout
Gout symptoms usually appear in a single joint. However, all joints should be examined to determine whether the arthritis is monoarticular or polyarticular. Affected joints often show signs of acute inflammation: swelling, warmth, redness, and pain.
The skin over the joint may become red and exhibit signs similar to cellulitis, with peeling occurring as the pain subsides. Additionally, the joint capsule quickly swells, leading to restricted joint movement.
Patients may also experience fever during acute gout attacks. However, it is important to identify any infected area causing septic arthritis or acute gouty arthritis.
In chronic gout, affected joints may become painful and swollen but typically do not show redness or warmth as seen in acute inflammation.
Sources: medscape.com, southerncross.co.nz, nhsinform.scot
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