Gout is a form of inflammatory arthritis. In gout, crystals of uric acid is deposited in and around the joints. For this deposit of urate to occur, the circulating level of uric acid in the blood must be higher than normal.

Gout has been recorded through the centuries. Hippocrates wrote about it and urate crystals were found in the big toe of an Egyptian mummy.

Gout is more prevalent in males and high in affluent societies. This may be a dietary factor. In the old days the rich ate the expensive red meat while the poor could only afford grain. Guess who developed gout?
Acute gout is rare in pre-menopausal women and it is predominantly a male disease up to the age of 50. It usually starts after 30 years of age and more commonly between 40 and 50 in males. In women the first attack is usually between 50-60 years.

The first attack of gout is usually in the big toe and this is called Podagra. 70-90% of first attacks present this way.

Pain often develops at night and within a few hours the pain level can escalate to severe and throbbing. The big toe will become red, hot, swollen and very tender to the touch. This acute attack will resolve spontaneously but can take weeks. Medical intervention often shorten this episode.

After this first attack your doctor is not likely to start you off on long term medication because you may not get another attack for years. On the other hand, you could have another attack in days.

Dr. Phil Hariram,

Arthritis Guide.