Gout is an acute arthritic disease which causes a sudden onset of intense pain usually in the big toe joint.  The  ”attack”(as it is called) commonly starts overnight with intense pain, localized heat and swelling around the big toe.  Gout is caused by the deposit of crystals composed of uric acid in the joint of the body.  Other joints may suffer attacks of gout but the big toe joint is the most common.  Uric acid is a breakdown product of protein metabolism by the body.  Foods high in amino acids called purines and pyrimidines are broken down into uric acid in the blood.  When the level of uric acid becomes too concentrated in the blood it starts to “settle out” in crystal form.  When these crystal deposit in the joint it starts a dramatic inflammatory response by the immune system. How is gout diagnosed? Gout may be diagnosed by a combination of clinical history and exam, blood tests, diagnostic imaging, or joint fluid analysis. Who gets gout? Gout affects men six times more frequently than women.People who have a diet high in foods that contain purines and pyrimidines.  These are red meat, organ meats, shellfish, sardines, and red wine are a few examples.Alcohol consumption can cause gout due to its diuretic(increase in urination) effect which ups the concentration of uric acid.Diuretics(water pills) such as furosemide (Lasix) also can increase the possibility of gout. Is gout dangerous?Repeated attacks or untreated cases can lead to permanent joint destruction with subsequent osteoarthritis.Gout can lead to kidney stone formation also.