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Gout is a metabolic disorder characterized by abnormalities in purine metabolism leading to hyperuricemia and deposition of monosodium urate crystals in joints and tissues. The most prominent symptom of gout is acute inflammatory arthritis, which typically presents as sudden, severe pain, swelling, redness, and warmth in a joint. The first metatarsophalangeal joint of the big toe is most commonly affected, a condition known as podagra, though ankles, knees, wrists, fingers, and elbows may also be involved. Attacks often begin _____ _________ ________ ______ __________.
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