Gout is characterised by sudden flare-ups or attacks followed by periods of no symptoms, known as remission. Gout attacks tend to occur suddenly without warning, often waking the individual up in the middle of the night, with a feeling like their big toe is on fire. In the initial stages, gout symptoms only occur in the big toe, but as gout progresses, other joints will be affected. 

When there is too much uric acid in your blood– a condition known as hyperuricaemia, it can form sharp crystals that accumulate in your joints, causing inflammation and pain.

• Sudden and severe joint pain (especially in the big toe)
• Swelling and redness in the affected joints
• Warmth and tenderness in the joint
• Limited range of motion and difficulty moving the joint
• Persistent discomfort that lasts for a few days to a few weeks
• Recurrent attacks of gout with periods of remission in between

The pain typically affects the big toe joint, but can also occur in other joints such as the ankles, knees, and wrists. The pain can last for days or even weeks, and can make it difficult to move or put weight on the affected joint.

Risk factors of gout include:

• Gender: men are more prone to developing gout than women. 
• Age: men are more likely to develop gout between the ages of 30 to 50 while women are more likely to develop gout after menopause.
• Weight: individuals who are overweight or obese are at a higher risk of developing gout because their bodies produce more uric acid. Studies have shown that losing weight can reduce the risk of gout. 
• Diet: diets rich in shellfish, red meat, and drinks high in fructose increase the risk of developing gout. 
• Alcohol: alcohol, especially beer, increases the risk of developing gout.
• Medical conditions: hypertension or high blood pressure, kidney disease, heart disease, or metabolic syndromes increase the risk of developing gout.
• Genetics: your risk of developing gout increases if your family members also suffer from gout.
• Medications: some medications such as aspirin, ACE inhibitors, or beta-blockers, increase the risk of developing gout.
• Trauma: recent surgery can also increase the risk of developing gout.

• Physical examination: your orthopaedist will usually start by reviewing your medical history and conducting a physical examination to check for signs of pain, inflammation, and tenderness. 
• Blood tests: to check the level of uric acid in your blood.
• Joint fluid test: to check for the presence of urate crystals. 
• Imaging tests: x-rays or ultrasounds may also be used to examine the affected joint.

Some of these treatment options include:

• Medications: non-steroidal anti-inflammatory medication (NSAIDs), colchicine, and corticosteroid can help relieve pain and inflammation during a gout attack. Allopurinol and febuxostat can help to lower the level of uric acid in your blood as well as prevent future gout attacks.
• Injections: corticosteroid injections can help to relieve pain and inflammation in the affected area.
• Lifestyle changes: avoid foods that are high in purines, limit alcohol consumption, maintain a healthy weight, and stay well-hydrated to prevent future gout attacks.
• Rest and elevation: rest the affected joint and elevate it to help reduce swelling and pain. Ice packs can also be used to help reduce inflammation.
• Joint aspiration: in some cases, your orthopaedist may conduct joint aspiration where a needle is used to remove fluid from the affected joint to relieve pain and reduce inflammation.