Acute gouty arthritis is most likely to involve the big toe, and the typical site of attack is the bunion. It is now believed that gout can also occur in other joints, including the knee, hip, shoulder, elbow, and even the wrist and finger joints. At present, the ankle and knee joints are also the most common sites. The occurrence of acute gouty arthritis may be related to exercise, as the most frequently affected area by exercise may be the big toe, followed by the ankle joint and finally the knee joint. The most exposed areas, especially the big toe, ankle or knee, are also most susceptible to weather. Fingers are also more likely to be exposed, but the first three are the most likely to occur. If acute gouty arthritis occurs, the areas most affected by changes in uric acid are the big toe, ankle and knee joints.