Gout has been academically considered to be a step-up disease consisting of different stages: acute gout, intercritical gout, and chronic gout. This simple approach may lead to misinterpretation and misdiagnosis. In clinical practice, we should consider gout as a single disease with either or both acute (most commonly, episodes of acute inflammation) and persistent clinical manifestations, but not restricted to chronic synovitis. In this article, an innovative, practical, and rational approach to the clinical manifestations and diagnosis of gout is presented, which may be supportive for clinicians involved in everyday care and management of patients with gout.
Key points
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Gout has been academically considered, from the clinical point of view, to be a step-up disease consisting of different stages: acute gout, intercritical gout, and chronic gout.
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In clinical practice, clinicians should consider gout as a single disease with either or both acute (most commonly, episodes of acute inflammation) and persistent clinical manifestations, but not restricted to chronic synovitis.
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Monosodium urate crystal (MSUC) deposition and subclinical inflammation related to MSUCs are also to be considered as (asymptomatic) gout, in contrast to asymptomatic hyperuricemia with no deposition.
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Comorbidities in Patients with Crystal Diseases and Hyperuricemia
Nonpharmacologic and Pharmacologic Management of CPP Crystal Arthritis and BCP Arthropathy and Periarticular Syndromes
Long-Term Management of Gout
Emerging Therapies for Gout
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