Gout presenting as non-union of a patellar fracture

We describe a 34-year-old man in whom non-union of a patellar fracture led to an unrecognized diagnosis of gout. He presented with a mass in the superolateral quadrant of the patella, which had the radiographic appearance of a non-united fracture. In the operating room, a gouty tophus was found. Although patellar tophi are uncommon, gout should be included in the differential diagnosis of non-united patellar fractures.