Gouty arthritis, known historically as "the disease of kings" and "rich man's disease" is not a relic of the past. Gout is a sudden attack of pain in the joints that occurs when uric acid builds up in the joints, especially in the feet and legs. The joint that is most commonly affected is at the base of the big toe, which is where it attacks in about 75% of initial attacks. Gout affects 1% of Americans at some point in their lifetime and is becoming more commonplace. 2% in men over the age of 30 and women over the age of 50 suffer from gout  

Hyperuricemia, or elevated blood uric acid levels, is the underlying cause of gout. About 10% of people with hyperuricemia develop gout. This can occur for a number of reasons including diet and genetics. About 12% of gout is attributed to dietary causes, which includes a strong association with the consumption of alcohol, sugar, and meat and seafood. A sedentary lifestyle also increases the risk of developing gout.

Dietary and lifestyle choices may decrease the risk of gout. Lowering intake of meat and seafood, consuming adequate vitamin C, limiting how much alcohol and fructose you consume, and avoiding obesity have all been shown to be effective in preventing gout. Both lifestyle changes and drugs can reduce uric acid levels. Medications however are not usually started until one to two weeks after an acute attack has resolved, because of theoretical concerns of worsening the severity of an attack.

The first written description of gout dates from 2,600 BC, when Egyptians noted gouty arthritis of the big toe. The Greek physician Hippocrates also commented on gout around 400 BC. Historical treatments for gout included gin and numerous other drugs that have since been found to be ineffective. Baking soda is a traditional remedy, thought to work by lowering blood acidity, but the added sodium is inappropriate for some people. As a side note, the Tyrannosaurus rex specimen known as "Sue" appears to have suffered from gout.