Since the disease was first recognized as a clinical entity by Sydenham in the 17th century, gout has attracted considerable attention. The protean nature of the disease has been described in detail by numerous observers. Contemporary descriptions emphasize that the basic process of the disease is the deposition of sodium urate in the mesenchymal tissues of the body. From the wealth of available literature, it appears that these acicular crystals are deposited in all but a few tissues. The commoner articular sites in which they are deposited include the joints of the feet, ankles, and wrists. Less commonly involved are the elbows, knees, shoulders, hips, sacroiliac, and sternoclavicular joints and the articulations of the spine. Abarticular tophi are classically found in the ears, the prepatellar and olecranon bursae, and the tendons of the fingers, wrists, toes, ankles, and heels. Deposition in the interstitial tissue of the kidney is not unusual.
Koskoff YD, Morris LE, Lubic LG. PARAPLEGIA AS A COMPLICATION OF GOUT. JAMA. 1953;152(1):37–38. doi:10.1001/jama.1953.63690010013007h
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