Gout is a crystal-associated arthropathy caused by uric acid deposition, with red, swollen and painful joints as its main clinical manifestation. Hyperuricemia is the basis of the disease and requires the precipitation of urate crystals and their deposition in the joints. 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 most common, especially in patients with first attacks of gout, and about 90% or more of them violate 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 an aggravation of the disease. Therefore, once there is a sudden onset of redness, swelling and pain in the first metatarsophalangeal joint, you need to be alert to the possibility of gout. If you have a history of hyperuricemia and a recent history of a high purine diet, such as alcohol consumption, this further increases the likelihood of gout and requires immediate medical attention.