Gout (also referred to as gouty arthritis) is a debilitating form of arthritis caused by the accumulation of uric acid crystals in the joints and tendons. It is an intensely painful disease that results from an increased uric acid concentration in the bloodstream. The most frequent location of symptoms is the 1st toe (75% of initial attacks), although it can also affect many other joints such as the ankle, knee, digits, and spine.