Before it comes to the first gout attack and the disease is discovered, there is often a gout disease for years. The phase in which the level of uric acid slowly continues to rise, but without symptoms, is called the asymptomatic phase. Typical gout symptoms become noticeable only when the mirror reaches a critical point and a gout attack occurs.
Pain in the toes
A gout attack typically causes severe pain. The joint in the big toe is especially common (Podagra). In addition to the pain, the joint may be reddish and heavily swollen and overheated. It is also extremely sensitive to touch. Partially, those affected can only occur on the heel, which leads to a limping walk.
In addition to the toe joint may also occur in a gout attack complaints in the thumb joints, knee joints, hocks and joints in the metatarsus. Failure to adequately treat the condition and adjust the lifestyle will result in chronic pain.
Uric acid deposits in the joints
In gout, the pain is caused by the deposition of uric acid crystals in the body. This is preferably done in the skin, the joints, the tendons, the ear cartilage and the bursa. As a result of the deposits then painful joint inflammation can arise.
If the inflammation is left untreated, chronic damage to the joints can occur in the long term. Likewise, damage to other organs, such as the kidney, possible. Here, the uric acid crystals also deposit and can lead over time to kidney stones and in the worst case to a malfunction of the kidney.
The deposits of the crystals sometimes form visible nodules. These are called gout-tophi. However, tophi only form when larger clumps of crystals are formed. Due to today's treatment options, this is rarely the case - often when gout is not treated.
The first attack of gout usually occurs completely surprisingly for those affected. Often these are healthy people who know nothing about their condition. An acute gout attack can last for several hours to a few days. Once the symptoms have subsided, the gouty attack is usually followed by a longer symptom-free phase.
If no therapy, but it can come again and again to gout attacks. Most of the time the symptoms get worse. Specifically, this means that the attacks occur at shorter intervals, last longer and can also spread to other joints. If the disease has a chronic course, serious complications can also occur. These include, for example:
- constant pain
- chronic arthritis
- Joint deformities
- Kidney stones, kidney failure and kidney failure
However, chronic gout is relatively rare. It only occurs if the disease is not treated or not treated properly.
Diagnosis of gout
On the basis of the typical symptoms, the doctor can often already make the suspected diagnosis of gout. By a blood test, the current uric acid level in the blood can then be determined. However, this must not necessarily be increased in a gout attack. Therefore, a regular measurement of the values is more meaningful than a one-time test.
In addition to a blood test, a urine sample can provide further information. Because while the uric acid level in the blood is usually elevated in gout, it is lower in urine than usual.
Joint puncture and X-ray
If, after the blood test, there are still doubts as to whether the patient is actually suffering from gout, a joint puncture with subsequent examination of the synovial fluid can produce a clear result. Under the microscope, the uric acid crystals are clearly visible in the liquid.
On the other hand, an X-ray examination makes little sense in the early stages of the disease. However, if there is an advanced course, an X-ray image may be helpful for diagnosis. In that case, there are often already visible changes to the joints.