When gout acute arthritis occurs, the most affected area is the first metatarsal and toe joints, that is, the big bunions and toes, which are usually asymmetrically involved, but other joints can also develop, for example, the dorsal foot, ankle, knee, finger and wrist joints in order of frequency. A small number of patients may experience fever, headache, and weakness. In acute gout attacks, the onset of the disease is usually rapid, and the attacks are usually at night, and the pain can be severe. Local manifestations include markedly elevated skin temperature, redness, and swelling, as well as limited joint movement and dysfunction.