Why does gout start with pain on the inside of the toes and then the ankle?

Gout starts with pain in the inner toes and later in the ankle because of an acute attack of gouty arthritis caused by the deposition of urate crystals into the ankle joint.
Excessive uric acid levels in the blood, the formation of urate crystals can be deposited into the joints, subcutaneous tissues, kidneys, etc., forming gouty arthritis, gouty stones and so on. Because urate crystals can be deposited in different parts of the body, it may cause pain in the inner toes at the beginning and then pain in the ankle, which may be accompanied by redness, swelling, burning sensation, restricted movement and other discomforts.
Gout patients should pay attention to strict low purine diet, eat more fresh vegetables and fruits, at least 2,000 milliliters of water per day, and the need to quit smoking and alcohol, avoid excessive exertion, but also need to moderate physical activity. In addition, it is necessary to follow the doctor’s instructions to take oral febuxostat, benzbromarone and other drugs to lower uric acid treatment.
If you find gouty arthritis manifestations such as redness, swelling and pain in the joints and fever, you need to go to the rheumatology and immunology department of a regular hospital as soon as possible, under the guidance of the doctor to carry out standardized treatment, and follow up on a regular basis.