Clinical Manifestations and Diagnosis of Gout Jung Soo Song Department of Rheumatology, Chung-Ang University College of Medicine, Seoul, Korea. drsong@cau.ac.kr Abstract Gout is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis involving, most commonly, the big toe, ankle, or other joints of the foot resulting from responses to the deposition of urate crystals from extracellular fluids supersaturated with urate. Middle aged men who are obese and drink alcohol regularly are the most susceptible. It is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints, and may cause joint destruction, decreased kidney function, and kidney stones. It is associated with metabolic syndrome including dyslipidemia, hypertension, hyperglycemia, and obesity. Gout is suspected when a patient reports a history of attacks of painful arthritis, particularly at the base of the toes. A confirmative diagnosis of gout requires demonstration of monosodium urate crystals in the synovial fluid, tophi, or tissues. Key Words: Gout, Uric acid, Acute arthritis, Renal insufficiency, Metabolic syndrome