Gout.

Symptoms

Symptoms

Attacks of gout usually develop very quickly. The first attack often occurs at night. You may go to bed feeling fine, but then wake up in the middle of the night with extreme joint pain.

During an episode you may notice:

• sudden, severe joint pain
• joint swelling
• shiny red or purple skin around the joint
• extreme tenderness in the joint area--the area may be so tender that even the touch of a bed sheet may cause severe pain.

An episode of gout can be triggered by:

• drinking too much alcohol
• eating too much of the wrong foods
• surgery
• a sudden, severe illness
• crash diets
• injury to a joint
• chemotherapy

Progression

At first, episodes usually are few and far between. They last only a week or so, and then everything seems to go back to normal, with no symptoms between episodes. If the disease is not controlled by medication, attacks may occur more often and may last longer. Repeated episodes can damage the affected joint(s). If your joints have been damaged, you may have joint stiffness and limited motion after an attack.

Gout generally occurs in three phases:

1. A sudden onset of joint pain and swelling (often in the big toe) that goes away after five to 10 days (or longer, in some instances).
2. A period of time when there are no symptoms at all, followed by other acute severe attacks.
3. After a number of years, if not treated, the development of persistent swelling, stiffness, and mild to moderate pain in one or more joints after numerous acute (generally severe, but short-lived) episodes.

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