Joint pain is the most common symptom in rheumatology, and more than 80% of patients in outpatient clinics may be seen in rheumatology for joint pain; however, joint pain is also the most complex. Almost all rheumatologic diseases can present with joint pain, either arthritis with inflammation and redness or simple, non-inflammatory, red and swollen joint pain. Huang Zhengping, Department of Rheumatology and Immunology, Guangdong Second People’s Hospital If you have joint pain symptoms, then you may have osteoarthritis, gout, or systemic lupus erythematosus, ankylosing spondylitis, or rheumatic fever, reactive arthritis, or psoriatic arthritis, dry syndrome, or vasculitis, scleroderma …… There are too many possibilities to say and explain. Therefore, if you have joint pain symptoms, please see a rheumatologist for answers. Gout is an acute or chronic inflammation and tissue damage caused by the deposition of monosodium urate in the bones and joints, kidneys and subcutaneous areas. Gout causes joint pain, also known as gouty arthritis, mainly refers to the redness, swelling, heat and pain of the joints induced by the deposition of uric acid in the bones and joints, accompanied by an increase in local skin temperature. With the increasing standard of living, lifestyle and diet structure are very different from before, the incidence of gout is also very high in China, reaching 0.34%-2.84%, and there are more than 20 million gout patients in China now. The pain is so severe and unbearable that it can even make people lose their ability to work and live, so gout has to be taken seriously. Who are the most common cases of gout? Gout is most common in men over 40 years of age and in post-menopausal women. Of course, in recent years, gout is getting younger and younger, and even children in their teens are getting gout, which may be related to dietary improvements and genetic factors. Gouty arthritis attacks require a process of uric acid deposition. As blood uric acid continues to increase, uric acid is slowly deposited in the joints, and when it causes an inflammatory response, gout attacks occur. Most of what we call a gout attack in everyday life refers to the joint pain caused by gout. Gout can strike after eating or drinking a lot (barbecue, hot pot or beer), or when you get cold, or after overexertion, or after trauma or infection, or for no apparent reason. Gout mostly occurs in the middle of the night or early in the morning, sometimes waking up with pain that is unbearable, heartbreaking, like a knife cut, or like a bite. The pain peaks within a few hours and can resolve on its own within a few days or 2 weeks. The course of the disease may be accompanied by systemic symptoms of fever. After repeated attacks of gout, all joints of the extremities, large and small, can be involved. The pain can also be less severe and can be mild. The most common site of onset is the first metatarsophalangeal joint, but it can also be found in the toe, ankle, wrist, finger and elbow joints. The first attack of gout tends to occur in one joint, and later the number of attacks increases and multiple attacks of gout may occur. As time passes, uric acid is deposited in and around the joints, and if left untreated, gout stones may form. The most typical site for gout stones is the auricle, but they can also be found around recurrent joints, the back of the foot, fingers, heel bone, and patella. This is when it becomes more difficult to deal with. Most patients seek medical attention during an acute attack of gout because the pain is unbearable, however, this time indicates that uric acid has already been deposited in the joints, somewhat like a mending process. Therefore, in the early stage of hyperuricemia, we should actively deal with it by seeking medical attention from a rheumatologist to lower the blood uric acid by various means, so as to stop the “wolf” of gout from brutally tearing our flesh.