Gout is very common in clinical practice and we all know that gout attacks are very painful due to the inflammatory response caused by the deposition of uric acid crystals in the joint area, resulting in joint pain. In clinical practice, it is found that the foot is usually first affected by the unilateral first metatarsophalangeal joint. The first metatarsophalangeal joint of the foot is located at the lowest end of the body, where the skin surface temperature is low, and the low temperature is conducive to the precipitation of urate crystals; at the same time, 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, the first metatarsophalangeal joint is the most common site of acute gout attacks, especially in patients with the first attack of acute gout, about 90% of the first attack on the first metatarsophalangeal joint of the foot. The onset of gout in the first metatarsophalangeal joint of the foot is sudden, often at night or in the early morning, with red, swollen, and painful joints that usually resolve on their own within a few days to 2 weeks. As the disease progresses, the acute gout attacks frequently, and the pain 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, gout is usually the first to invade the first metatarsophalangeal joint of the foot, once the sudden onset of the first metatarsophalangeal joint redness, swelling, heat and pain, 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 drinking alcohol or eating large amounts of seafood, the possibility of gout is further increased and you need to seek immediate medical attention.