A gout attack typically causes pain, swelling, redness, and warmth (inflammation) in a single joint, most often the big toe.

What makes big toe more susceptible for gout?

Also I was said that it mostly occurs in right big toe, if this is correct then what could be the reason for its right sidedness?

Source : http://www.webmd.com/arthritis/gouty-big-toe

  • $\begingroup$ That link doesn't say anything about the right side being more often affected. $\endgroup$
    – kmm
    Commented May 6, 2017 at 16:45
  • $\begingroup$ it was told in my class by the lecturer. $\endgroup$
    – JM97
    Commented May 6, 2017 at 16:47
  • $\begingroup$ Then I think you should drop the part about the right toe. Without a peer reviewed source, I don't think it's relevant. $\endgroup$
    – kmm
    Commented May 6, 2017 at 17:05
  • $\begingroup$ Edited the title. the part about right toe is now subordinate. $\endgroup$
    – JM97
    Commented May 6, 2017 at 17:12

1 Answer 1


The question has been explored in great depth in the cited paper. Have a look.

Roddy E. Revisiting the pathogenesis of podagra: why does gout target the foot?. Journal of foot and ankle research. 2011 May 13;4(1):13.


  1. Nucleation factors: The site of Gout depends on where the Monosodium Urate (MSU) crystals are likely to form. This process of nucleation depends on a variety of factors. One is temperature, its solubility decreases with temperature and hence the fingers and the toes are more likely sites of MSU precipitation. Further, trauma and pH also affect the nucleation. Repeatedly stubbing a toe makes the first metatarsophalangeal joint (MTPJ) specifically vulnerable.

  2. Cartilage damage and Osteoarthritis(OA).OA sites are correlated with those of higher MSU deposition and cartilage damage (for reasons and evidence, refer to the cited paper). Hence, factors which make MTPJ more susceptible to OA can increase the predilection for MSU deposition. These include "increased concentrations of chondroitin sulfate, degradation of protein-polysaccharide complexes, and epitaxial MSU crystal nucleation and growth on cartilage fragments"

The right sided predilection might be because most people are right-handed, and they might be more likely to injure or stub their right toe.

  • $\begingroup$ Is it true that it also attacks mostly right side? $\endgroup$
    – JM97
    Commented May 7, 2017 at 15:45
  • $\begingroup$ See the edit @JM97 $\endgroup$ Commented May 7, 2017 at 15:46
  • $\begingroup$ could you answer this: biology.stackexchange.com/questions/58779/… ? $\endgroup$
    – JM97
    Commented May 7, 2017 at 15:48
  • $\begingroup$ @JM97 I went through the question. I couldn't find a satisfactory resolution of the query, only peripheral hints and such. Will post, in case no one does. $\endgroup$ Commented May 7, 2017 at 16:25

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