Tophaceous gout with rare involvement of the patella

Gout arthritis is an inflammatory arthritis caused by hyperuricemia from various etiologies. It is typically a polyarticular arthritis with the most common joint involved being the first metatarsophalangeal joint. We present a case of gout of the knee with characteristic magnetic resonance imaging findings and rare involvement of the patella. Radiographic findings of gout are diagnostic; however, they manifest many years after the onset of the disease process. Control of symptoms and progression of the disease is possible with correct treatment made possible by early diagnosis.