There are four stages of gout. By reviewing the X-rays of one stage with the next, it is possible to identify the changes and if necessary, progression.
There is also an asymptomatic hyperuricemia, which does not show up on a X-ray. The uric acid levels will be elevated but there will be no other symptoms. Treatment is not usually given at this time.
In the acute gout or gouty arthritis stage, hyperuricemia or the elevated deposits of uric acid have caused crystals to form in the joint spaces. This results in sudden and intense pain and swelling in the joints. There will be tenderness and the joint may be warm to the touch.
The word acute means sudden onset. The acute attack most often occurs at night. Stress can trigger the attack.
Interval or intercritical gout is the third stage and happens between acute attacks. There may be normal function of the joint and no symptoms.
The fourth stage is chronic tophaceous gout. This is the disabling state and may happen after 10 years. Permanent damage to the joint has occurred by now and there even may be kidney damage. If properly treated, most afflicted with this condition will not progress to this stage.
The X-rays along with the lab results are how your doctor defines gout and what stage it is in.
It should be noted that there is a difference between gout, which often affects the toes and Sudogout or Pseudogout which most often affects the knee joint. There is also a difference in the level of pain experienced in each of these conditions. Pseudo gout often is said to be more painful.
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