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The large joint at the base of the big toe (first metatarsalphylangeal joint) is the most common site for a gout attack but other joints commonly affected are the ankles, knees, wrists, fingers, and elbows.
Signs and symptoms of gout include: 1  Hyperuricemia (high level of uric acid in the blood). 2  Uric acid crystals in joint fluid. 3  More than one attack of acute arthritis. 4  Arthritis that develops in 1 day, producing a swollen, red, and warm joint. 5  Attack of arthritis in only one joint, usually the toe, ankle, or knee.or many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen. Gout can cause: 1  Pain. 2  Swelling. 3  Redness. 4  Heat. 5  Stiffness in joints.