A 54-year-old man presented with acute swelling and pain in the posteromedial aspect of the knee not involving the joint itself. Aspiration of the soft tissue swelling produced viscous fluid in which multiple, negatively birefringent crystals were noted on compensated polarized microscopy. The first described case of acute gout involving the sartorial ridge, this case underlines the need for examining aspirated fluid from soft tissue as well as from joints for crystals.
