An attack often occurs very suddenly with the maximum intensity of pain reached within a few hours. The joint involved can be extremely painful and is often swollen, warm and red. This rapid development of joint pain is a feature that differentiates it from most other forms of arthritis.

The most common joint affected is the first joint of the big toe. Other joints that may be affected are the knee, ankle, foot, hand, wrist and elbow joints. The shoulder, hip joints and the spine are rarely affected.