The first symptom you are likely to notice is very bad pain in one of your joints. This most often happens in your big toe. It comes on suddenly, over a few hours.
People often get attacks of gout at night. The pain may wake you from your sleep. The joints most likely to get gout are in the big toe, foot, ankle, knee, wrist, finger, and elbow. 
Your affected joint usually swells up. The skin around it may look red, shiny, and inflamed. You may also notice that: 
The pain is worse if you bump the joint. You may find that even the weight of the bedclothes over your foot makes it too sore to bear.
Sometimes, urate crystals form under the skin, on your hands, knees, wrists, elbows, and ears. They look like white bumps. Doctors call these bumps tophi.
Doctors can usually diagnose gout by examining your swollen joint. The doctor will probably also do a blood test, to check how much urate you have in your blood. If you have a high level of urate, it's more likely that gout is causing the problem.
If your doctor is not sure whether you have gout, another test may be done. The doctor will take some of the fluid out of the swollen joint, using a needle and syringe, and send it to the laboratory. The laboratory will then look at the fluid under a microscope. If you have gout, they may be able to see urate crystals in the fluid. 
For references related to Gout click here