1. Gout attacks may begin anytime but frequently start at night.
2. Sometime during the course of the disease, gout usually affects the joints in the big toe. The big toe becomes swollen, red, and painful.
3. To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of joint fluid for analysis under a microscope.
4. If monosodium urate crystals are seen when looking at the fluid under a special microscope, the person usually has gout.
5. Gout usually affects a single joint. In rare cases, many joints are affected at the same time. Gout frequently affects a joint in the lower part of the body such as a knee, ankle, or toe. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients.
