Overview
Gout is a metabolic disorder of purine metabolism, characterized by intermittent attacks of acute pain, swelling and inflammation. Most common site of initial attack metatarsophalangeal joint of the great toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.
Pathophysiology
The deposition of uric acid crystals is usually secondary to relatively high levels in the blood. This can occur because of diet, genetic predisposition, or underexcretion of uric acid