
La fase asintomatica è quella iniziale, durante la quale nella persona affetta da iperuricemia inizia l’accumulo di cristalli di urato intorno a tendini ed articolazioni. Sebbene non si avvertano sintomi, questa è una fase importante perchè inizia l’effetto dannoso del deposito.
La fase acuta si verifica quando l’accumulo dei cristalli provoca un’infiammazione. Di riflesso ciò provoca dolore, arrossamento, gonfiore, e vampate di calore che possono durare giorni o addirittura settimane.
Il dolore può essere sia lieve che straziante, e nella maggior parte dei casi gli attacchi dolorosi si verificano nei piedi.
Circa il 50% delle persone affette da gotta localizzano il male a livello dell’articolazione I metatarso falangea (l’alluce).
Negli anziani il dolore può presentarsi in modo diverso e maggiormente diffusi a diverse articolazioni.
Esiste una fase intermedia durante la quale la gotta non manifesta sintomi, una sorta di pausa prima del verificarsi di un altro attacco doloroso. In questa fase tuttavia l’iperuricemia non cessa, e continua incessante l’accumulo dei cristalli di urato.
Mano a mano che la malattia progredisce le fasi intermedie asintomatiche diventano sempre più brevi.
La gotta cronica è caratterizzata da una forma di artrite, anch’essa cronica, che si manifesta con irritazioni e forti dolori ai giunti articolari.
Nelle persone con la gotta possono anche verificarsi accumuli di cristalli di acido urico, i tofi, nelle articolazioni di altre zone del corpo, prevalentemente nelle aree più fredde come i gomiti, le orecchie o nei giunti distali delle dita.
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