Gouty foot. X-ray image of a foot affected by gout (gouty arthritis). Gout is a metabolic disease in which the body has high levels of uric acid. Acid crystals are deposited in joints, leading to extremely painful arthritis. Recurring attacks may cause joint deformity, deposits in soft tissue (tophi) and kidney damage. The cause of the metabolic defect is not known, but risk factors include obesity, diabetes mellitus and kidney disease. Attacks may be triggered by intake of purines in the diet, from certain rich foods, beer and wine. Treatment is with drugs to lower uric acid levels.