Overview Gout is an acute, crystalline induced monoarticular arthritis of the first metatarsophalangeal joint. Deposition of uric acid crystals in the joint fluid results in an inflammatory response that manifests as acute swelling, redness, and fever. Gout can also affect the hawser and patellar bursa, the tendon synovial sheaths of the group and dorsum of the foot, and other small joints of the foot. Physical examination Acute swelling, redness, and warmth of the metatarsophalangeal joints; marked pressure pain; and even slight movement of the joint can cause increased pain Diagnosis X-ray is recommended in patients with recurrent or chronic gout. Often needs to be differentiated from infectious arthritis. Treatment The aim is to rapidly reduce the acute inflammation of the joint. Ice and elevation of the patient; avoidance of shoe compression; nonsteroidal anti-inflammatory drugs; uric acid-lowering drugs. Prognosis Long-term control of gout depends on prevention. Aspirin, alcohol, foods with high purine content and some specific medications (especially diuretics and niacin) must be avoided for the first few rounds. Allopurinol or probenecid may be used in chronic cases.