Gout attack commonly occurs at this site

The correct answer is big toe.

Gout is a painful form of inflammatory arthritis caused by the accumulation and precipitation of monosodium urate (uric acid) crystals in the joints. An acute gout attack most commonly occurs at the first metatarsophalangeal (MTP) joint, which is the joint at the base of the big toe. A gout flare at this specific site is clinically referred to as podagra.

There are two primary physiological reasons why the big toe is the most susceptible site:
1. Temperature: As a distal extremity, the big toe has a lower temperature compared to the body's core. Uric acid is less soluble at lower temperatures, which facilitates the crystallization of monosodium urate in this joint.
2. Mechanical Stress: The metatarsophalangeal joint of the big toe bears significant weight and repetitive impact during walking and daily movement. This repeated microtrauma and pressure make the joint highly vulnerable to crystal deposition and subsequent inflammation.