When you think gout, think TOE, because that’s where it loves to start. The big toe joint, or first metatarsophalangeal joint, is the classic site for that sharp, fiery pain that wakes people at night.

Now add TOPHI spelled T-O-P-H-I those are the chalky white deposits that form when uric acid crystals build up over time. Think of them as little mountains of urate that appear on ears, elbows, or even fingers.

So remember: TOE for the first attack, TOPHI for the chronic stage.
Gout begins in the toe and ends with tophi. It's a simple way to recall the progression from acute inflammation to long-term crystal buildup.

That’s your minute mnemonic — TOE and TOPHI — from acute pain to chronic deposit.”