Intense pain that hit in the middle of the night
Gout flares are more likely to occur between midnight and 8 a.m. than during the day. This can be due to certain factors, including being more dehydrated overnight and lower body temperature, which allow uric acid crystals to accumulate more readily.
Pain in your ankles, knees, wrists, or elbows
While urate crystals tend to deposit near the big toe, they can accumulate in any joint in the body. This means unexplained, moderate to severe pain in any joint.
Some people may develop pain and other associated signs in just one joint (for example, the left knee), but about 30 percent of patients develop “polyarthritis” – meaning they develop symptoms in more than one joint at a time.
When gout involves multiple joints, it’s hard to diagnose the condition because it mimics other joint diseases like rheumatoid arthritis.