There are four stages of gout. A person who is in the first stage, asymptomatic hyperuricemia, has elevated levels of uric acid in the blood but no other symptoms. In the acute stage, a person experiences a sudden onset of intense pain and swelling in the joints. The interval or intercritical stage is the period between gout attacks, in which a person has normal joint function and no symptoms. Chronic tophaceous gout, the last of the four stages, is characterized by permanent damage to the affected joints and sometimes to the kidneys.
The four stages of gout are as follows:
- Asymptomatic hyperurecemia
- Acute gout (also known as acute gouty arthritis)
- Interval or intercritical gout
- Chronic tophaceous gout.
Asymptomatic Hyperuricemia (Without Symptoms)
In this stage of gout, a person has elevated levels of uric acid in the blood but no other symptoms. A person in this stage does not usually require treatment.
Acute Gout (Acute Gouty Arthritis)
In this stage, hyperuricemia has caused the deposit of uric acid crystals in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which also may be warm and very tender. An acute gout attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Early gout attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently.
Interval or Intercritical Gout
This is the period between acute gout attacks. In this stage, a person does not have any symptoms and has normal joint function.
Chronic Tophaceous Gout
This is the most disabling gout stage, and it usually develops over a long period of time, such as 10 years. In this stage, the gout has caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout do not progress to this advanced stage.