Gout is a painful form of arthritis that affects more than a million Americans annually. Using a case study, a discussion of the clinical onset, signs and symptoms, diagnosis, and treatment of acute and chronic gout is presented. The incidence and etiology of gout is presented, along with current diagnostic criteria and the most common differential diagnoses to consider. The current trends in diagnosing and treating the acute and chronic forms of gout are also addressed as well as some of the controversies and concerns about treatment options. The treatment plan and follow-up for the patient in the case presentation conclude the discussion.