Recently gout has been recognized as a cause of inflammation in patien
ts with nodal osteoarthritis. We reviewed the clinical data and radiog
raphs of four patients with known osteoarthritis of the interphalangea
l joints of the hands who developed gout. Radiographic changes of oste
oarthritis in the affected interphalangeal joint were present in all f
our patients. In our cases, radiographic findings were typical of gout
in one patient, including the presence of large eccentric soft tissue
masses and periarticular erosions. In three patients, radiographic fi
ndings second, and a large calcified soft tissue non-specific, includi
ng only a small eccentric nodule in one patient, diffuse soft tissue s
welling in a sue mass with bony erosions in a third. Whenever a patien
t with interphalangeal joint osteoarthritis presents with an acute epi
sode of inflammation the possibility of gout should be considered. Rec
ognition of gout will allow the timely initiation of appropriate thera
py.