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. 2021 Jul 30;17(10):633–641. doi: 10.1038/s41584-021-00657-4

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Gout progresses through several classic disease stages and corresponding clinical manifestations. In some cases, advanced disease stages and complications can appear prematurely, without earlier disease stages or clinical manifestations being apparent (for example, tophaceous gout without prior gout flares), although this pattern is uncommon. MSU, monosodium urate. Adapted from ref.⁸⁰, Springer Nature Limited.