Yes. Gout is the most common form of inflammatory arthritis. It differs from osteoarthritis, which is gradual wear of the joint surface, because gout is driven by crystals and an immune reaction. Flares come and go, but each one can leave the joint a little more damaged. That is why long-term uric acid control matters as much as treating the attack in front of you.

A GP diagnoses gout, usually from the pattern of the flare plus a blood test for uric acid. Blood levels can read normal during an attack, so a normal result does not rule it out. The most definitive test is drawing a small sample of joint fluid to look for urate crystals. Ultrasound and specialised CT can also show crystal deposits.

Often, yes. Much of your uric acid level is set by how your kidneys clear it, and that is strongly genetic. If a parent or sibling has gout, your risk is higher. Genes are not the whole story though. Kidney function, blood pressure medications such as diuretics, body weight and alcohol intake all shift your levels, and those parts can be worked on.

Not during an acute flare. Loading a joint full of urate crystals prolongs the inflammation, so rest and elevate it until the swelling drops. Between flares, regular activity is helpful, because it supports weight management and blood pressure. Low-impact options such as swimming, cycling and walking in supportive shoes put less strain through the big toe joint than running or court sports.

They are called tophi. Tophi are firm, chalky collections of urate crystals that build up under the skin, commonly over the big toe joint, the outside of the foot, the Achilles tendon and the elbows. They are usually painless but they press on footwear, and the skin over them can break down and become infected. Your podiatrist monitors and protects these areas.

Not necessarily. The big toe joint is the most common site, but flares can move to the midfoot, ankle, heel, knee, wrist or fingers. Early on, gout usually strikes one joint at a time. If it goes untreated for years, several joints can be involved at once and the pain can become more constant rather than coming in clear attacks.