Sudden onset of redness, swelling and hot pain in a single joint is a common clinical manifestation of an acute attack of gout, with the lower extremity joints being the most common, especially the first metatarsophalangeal joint (commonly known as the big toe joint). Gout is an acute and chronic inflammation and tissue damage caused by the deposition of uric acid in the bones and joints, kidneys and subcutaneous areas. Hyperuricemia is the basis for the development of gout and requires the precipitation of urate crystals and their deposition in joints and other areas to cause the disease. Temperature, blood volume, and blood flow rate are all important factors that affect the precipitation and deposition of urate crystals. The first metatarsophalangeal joint of the foot is located at the lowermost part of the body and has a low surface temperature, which is conducive to the precipitation of urate crystals, while the blood flow rate at the first metatarsophalangeal joint is relatively slow, which is conducive to the deposition of urate crystals. In view of this, acute gout attacks in the first metatarsophalangeal joint are the most common, especially in patients with the first attack of gout, about 90% or more invade the first metatarsophalangeal joint. However, as the disease progresses, acute gout attacks are frequent, and the site can gradually move up from the first metatarsophalangeal joint to the ankle, knee, finger, wrist, elbow and other joints, which mostly indicates the aggravation of the disease. If the disease is not controlled by regular treatment, acute gout can be frequent attacks can form gout stones and chronic arthritis period, gout stones deposited in the skin, joints, and even in the kidneys, resulting in hematuria, proteinuria, edema, anemia, hypertension, renal colic and other symptoms. Therefore, gout attacks are most common in the first metatarsophalangeal joint, especially in patients with previous hyperuricemia, who should suspect gout attacks and go to the hospital for timely examination and treatment.