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Don't be surprised if symptoms appear suddenly. They often occur at night. Symptoms are usually the most painful within the first 4 to 12 hours after the initial attack. These symptoms include: Intense joint pain: in feet (often at the base of the big toe), ankles, knees, or wrists Joint discomfort after the initial attack Redness and other signs of inflammation, like warmth, swelling and tenderness Difficulty moving the affected joint There are some risk factors you can't control, like a family history of gout or the prevalence of gout in adult men and postmenopausal women. But, you can control other risk factors like being overweight (or obese), untreated high blood pressure, diabetes, metabolic syndrome, and heart and kidney disease. Recent surgery or trauma also increases your risk for gout. If you are unsure whether you have gout, talk with your doctor. Your doctor will make a diagnosis based on your symptoms and medical history. Further testing and lab work might be needed. Testing may include taking a sample of joint fluid, running a blood test to see your uric acid levels, or getting an X-ray, ultrasound, or CT scan (although imaging tests aren't usually used). Joint fluid is analyzed for the presence of urate crystals that are visible under the microscope.

Summary:
Watch for gout symptoms. Consider your risk for gout. Get a diagnosis of gout.