ABSTRACT
Acute gouty arthritis usually presents as a monoarthritis (Figure 7.1) classically affecting the big toe (in 50% of cases). Symptoms produce the classic signs of inflammation, erythema, swelling, redness, heat, pain and loss of movement (Figure 7.2). The attack often starts with severe pain usually at night but rarely lasts more than two weeks. Between acute attacks the patient is asymptomatic, but 60% of patients have a further attack in the first year.
