College of Massage Therapists of British Columbia (CMTBC) Practice Exam

In the case of a patient with acute gout, which body part is most likely affected?

1. Ankle

2. Knee

3. Big toe

4. Wrist

The correct answer is: Big toe

Acute gout typically presents as sudden and severe pain, often occurring in the joints. The most commonly affected body part in an acute gout flare is the big toe, specifically the metatarsophalangeal joint. This phenomenon is often referred to as "podagra." The reason the big toe is primarily affected is due to its physiological and anatomical characteristics; it experiences higher concentrations of uric acid, which crystallizes in cooler temperatures, making it more susceptible to the development of gout. While other joints, such as the ankle, knee, and wrist, can also be involved in gout attacks, they are less characteristic of the initial presentation of the condition. Gout is linked to hyperuricemia, where excess uric acid in the blood forms sharp crystals that deposit in the joints, leading to inflammation and intense pain. In patients presenting with acute gout, healthcare professionals look for swelling, redness, and tenderness in the big toe as a hallmark sign of the condition.