Gout Symptoms - A Description

Gout (hyperuricemia) is a form of arthritis. It is a syndrome in which monosodium urate monohydrate crystals are deposited in tissue from extracellular fluid in supersaturated form. Urate crystal deposition in tissue leads to inflammation and later degeneration of soft tissues and joints. Gout symptoms were first described by Dr. Thomas Sydenham in the seventeenth century.

His description of symptoms of gout still holds good today. Typical gout symptoms and signs consist of awakening due to severe pain in the great toe about 2 a.m. at night. This is after the patient has gone to sleep without any ill health. The severe pain is akin to that during a dislocation. The moderate level pain is followed by shivers and chills and a slight fever. It gradually increases to an intense one.

It is so excruciating and intense that the person afflicted by it cannot even bear the slightest jar due to another person's entrance in the room. Further, the person cannot bear to keep the toe covered with bedclothes.

More infrequently, the pain may begin in the instep, heel, knee, or ankle in place of the great toe.

The first acute attack (above cited symptoms) of gout appears in males in the 35 to 50 years age bracket. In females, they first occur 15 to 20 years after menopause. In males, such symptoms first appear in a single joint (monoarticular attacks) after they have gone without symptoms for 15 to 20 years. Gout has a tendency to show symptoms in the joints of the lower extremities.

They typically appear in the first metatarsophalegeal joint (podagra), midfoot, knee, and ankle. With time, such attacks move to the upper extremities. The affected joints there are those of the elbow, the wrist, and the hands' small joints. In elderly people, it is more common to have several upper extremity joints (polyarticular attacks) affected by gout symptoms.

Typical symptoms of an attack are the sudden redness, severe pain, disability, and swelling noticed over several hours. Surprisingly, even with no treatment, the symptoms subside after a few days or after the elapse of a maximum of two weeks. After the symptoms subside, the skin may peel off from the site of such attacks.

After this, a phase, in which no attacks are experienced, follows. However, if gout is left untreated during the phase, more such attacks follow, with shorter no-attack phases.

During anytime in the 15 to 20 years following the initial attack, untreated gout may lead to the appearance of tophi. Tophi (chalky deposit of sodium urate) can occur at any location on the body..

Pseudogout is a hereditary form of arthritis associated with chondrocalcinosis.

The diagnosis of gout is made by using a needle probe to find negatively splitting needle-shaped sodium urate crystals (tophi) under a polarized microscope.

No cure for gout exists. Treatment for gout is for aborting or preventing appearance of future gout symptoms and also for treating chronic hyperuricemia.