ABSTRACT
Gout is a disease caused by the deposition of monosodium urate monohydrate
crystals in joints and surrounding tissues. Symptomatic crystal deposition
includes attacks of, typically, acute monoarticular arthritis; tophi, which elicit a
chronic inflammatory response causing a destructive arthritis; and urolithiasis.
The natural course of classic gout passes through three stages: asymptomatic
hyperuricemia, acute intermittent gout, and chronic tophaceous or advanced gout
(Fig. 1). The rate of progression from asymptomatic hyperuricemia to chronic
tophaceous gout varies considerably from one person to another and is dependent
on numerous endogenous and exogenous factors. The clinical manifestations of
urate crystal deposition and the natural history of gout are reviewed in this chapter.
STAGES OF CLASSIC GOUT
