Podagra, which is severe inflammatory arthritis at one metatarsophalangeal joints, is the most common manifestation of gout. Patients often describe awakening in the middle of the night with severe pain, redness and swelling. Gout flares can lead to severe forms of inflammatory arthritis. Gout flares most often occur at the toes, but also in the ankles, knees, midfoot, ankles, and midfoot. Gout flares are often caused by conditions that increase serum uric acid levels, such as metabolic stressors that lead…