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The large joint at the base of the big toe (first metatarsalphylangeal joint) is the most common site for a gout attack but other joints commonly affected are the ankles, knees, wrists, fingers, and elbows.
Pain in the Big Toe. Gout is a notorious cause of sudden pain in the big toe joint, along with redness and swelling (seen here). Osteoarthritis is another culprit that causes pain and swelling. If the joint is rigid, it may be hallux rigidus, a complication of arthritis where a bone spur develops.