Typically the very first sign of gout -- a form of arthritis sometimes called "arthritic gout" -- is a suddenly swollen, hot, painful, and ugly-looking big toe.
Gout is caused by too much uric acid, a natural substance. When it builds up, it forms needlelike crystals, especially at low body temperatures. And what's the coolest part of the body, farthest from the heart? The big toe.