In clinical practice, the first reason for ankle pain is rheumatic or rheumatoid arthritis, which mainly involves the synovium of the joint in the early stages, causing synovial hyperplasia and effusion leading to pain. The second cause is gout, which is due to dietary habits, such as frequent consumption of greasy or seafood-based foods, and a preference for beer, leading to increased uric acid levels and gout. The third cause is osteoarthritis in middle-aged and elderly people, which leads to degeneration of joint cartilage and pain. The fourth cause is sprains, which can lead to damage to cartilage and ligaments within the joint, causing pain. To determine whether ankle pain is caused by gout or rheumatic arthritis, one can simply visit a hospital for a checkup, such as a uric acid test to see if there is a significant increase in gout uric acid levels. If the uric acid level is significantly elevated, it is likely caused by gout. Additionally, one can check for a rheumatism panel to see if the anti-O test is positive; if it is, it may suggest that rheumatic factors are causing the pain.