The early stage of gout generally refers to the asymptomatic stage, but many patients do not know they have gout until they develop swollen and painful joints, because in the asymptomatic stage of gout, patients may not have any discomfort, so joint swelling and pain are generally considered the first manifestation of gout. Gout is a crystal-related arthropathy caused by uric acid deposits, and hyperuricemia is the basis of gout. The asymptomatic period of gout can last for years or decades, and is related to many factors such as gender, age, history of hyperuricemia, and the level of uric acid in the blood, etc. There is usually no aura before an acute attack of gout, and it often strikes suddenly at night or in the early morning. Although joint symptoms may resolve on their own within a few days or 2 weeks or even disappear without medication, if the disease is not well controlled, acute gout can strike frequently, each time with similar circumstances and without aura symptoms. Therefore, in terms of symptoms alone, swollen and painful joints are the early manifestation of gout, indicating that gout has already struck. However, from the perspective of examination and laboratory tests, elevated blood uric acid level is the “early manifestation” of gout. If elevated blood uric acid is detected, it is important to seek immediate medical attention and treatment to prevent an acute attack of gout.