The radiological features of gout are presented on the basis of a consecutive series of 64 in-patients and a review of the literature. Gout is a painful and potentially crippling disorder. Since fewer patients are referred with a classical acute attack due to the advent of more effective drug therapy, the radiologist may be presented with unusual or atypical cases. It is confirmed that there are no specific radiological features of gout. Provided a high index of suspicion be mai-tained, particularly in those groups of patients in whom secondary gout is common, a combination of signs may allow the diagnosis to be correctly inferred, leading to biochemical confirmation.