How does an acute attack of gout most commonly present?

An acute attack of gout most commonly presents as severe sudden joint pain with swelling. This classic presentation occurs because gout is caused by the crystallization of uric acid in the joints, leading to intense inflammatory responses. Patients typically experience a sudden onset of excruciating pain that often peaks within 12 to 24 hours, along with significant swelling and tenderness in the affected joint.

The most commonly affected joint is the metatarsophalangeal joint of the great toe, although other joints can also be involved. The intense pain and inflammation during an acute attack make it distinct and recognizable among other forms of arthritis.

As for the other options, they represent symptoms that do not align with the acute nature of a gout attack. Asymptomatic swelling and pain would suggest a chronic or less overt presentation, which is not typical of acute gout attacks. Chronic pain in multiple joints is more characteristic of conditions like osteoarthritis or rheumatoid arthritis. Mobility-related pain with limited range of motion might occur in various types of arthritis but does not specifically capture the explosive onset and intense nature of pain seen during an acute gout episode.