Gout is a common disease and often presents suddenly with a painful joint. The most common and well-recognized symptom is swelling of the joint in the big toe where it joins the foot. This can be extremely painful and enlarged and if not treated the pain will last about 10 days and can cause lasting damage with repeated attacks. The area can be red, hot, inflamed and very painful or tender.

Kidney stones can form due to gout and can cause back pain. Other joints such as the knee, fingers and heel can also be affected. Some people get lumps on the rim of the ear or other parts of the body near joints under the skin and these are called tophi.

Over the long term there can be deformity of joints and there can be many large lumps under the skin. Nowadays with proper treatment this is less likely. The symptoms can last from three to ten days and often get better even without treatment. The next attack may occur many months or even years later. Usually (and fortunately) only one joint is affected at a time and the symptoms of the swelling and pain start within a day.

The definite diagnosis or determining if the arthritis is due to gout may involve drawing fluid from the joint and looking for crystals of uric acid.

People may have an elevated uric acid also called hyperuricemia but have no symptoms. Later they may develop acute gouty arthritis where the joint is affected. Almost three fourths of people with gout will develop it in the big toe at some point of time. In between attacks the gout is said to be in an interval or intercritical phase and finally some people get chronic tophaceous (with the tophi) gout.

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