What Are The Stages of Gout?

There are several stages of gout:

• Asymptomatic hyperuricemia is the period prior to the first gout attack. There are no symptoms, but blood uric acid levels are high and crystals are forming in the joint.
• Acute gout, or a gout attack , happens when something (such as a night of drinking) causes uric acid levels to spike or jostles the crystals that have formed in a joint, triggering the attack. The resulting inflammation and pain usually strike at night and intensify over the next eight to 12 hours. The symptoms ease after a few days and likely go away in a week to 10 days. Some people never experience a second attack, but an estimated 60% of people who have a gout attack will have a second one within a year. Overall, 84% may have another attack within three years.
• Interval gout is the time between attacks. Although there is no pain, the gout is not gone. Low-level inflammation may be damaging joints. This is the time to begin managing gout via lifestyle changes and medication to prevent future attacks or chronic gout.
• Chronic gout develops in people with gout whose uric acid levels remain high over a number of years. Attacks become more frequent and the pain may not go away as it used to. Joint damage may occur, which can lead to a loss of mobility. With proper management and treatment, this stage is preventable.

How Do Doctors Diagnose Gout?

Tests to help diagnose gout may include:

• Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. Urate crystals may be visible when the fluid is examined under a microscope.
• Blood test. Your doctor may recommend a blood test to measure the levels of uric acid and creatinine in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don't have unusual levels of uric acid in their blood.
• X-ray imaging. Joint X-rays can be helpful to rule out other causes of joint inflammation.
• Ultrasound. Musculoskeletal ultrasound can detect urate crystals in a joint or in a tophus. This technique is more widely used in Europe than in the United States.