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Acute gout classically presents as a sudden onset of severe joint pain, most commonly affecting the first metatarsophalangeal joint, a condition known as podagra. The attack often begins at night or in the early morning hours and reaches peak intensity within 24 hours. The affected joint becomes intensely painful, swollen, warm, erythematous, and extremely tender __________ ________ __________ ________ _____ ______ ___ ______ ___ ________ _________.
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