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The inflammatory process in gout is unrelated to infection.
Signs and Symptoms- Rapid onset of severe joint pain, swelling and redness, often beginning at night after ingestion of alcoholic beverages, uric acid-elevating medications or high-purine foods.
- In 90% of initial episodes a single joint is involved - especially the joint at the base of the big toe. Gouty arthritis of the big toe afflicts some 90% of patients some time during the course of their disease. The foot, heel, ankle, knee, hands, wrists and elbows are some of the other joints that are frequently involved.
- Attacks tend to last a few days to a few weeks.
- Attacks respond well to medications.
- The frequency of subsequent attacks is variable. 5-10% of patients will never be bothered again, but most relapse within a year.
Untreated cases may develop chronic gouty arthritis in which multiple joints are involved by a long-term destructive process. However, uric acid levels in the blood alone are often misleading and may be transiently normal or even low.
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