“…This has been previously pointed out by Verhoeff and King (1938) in their discussion of rheumatoid scleromalacia perforans. That joint involvement can occur as the result of a metabolic disease is seen not only in gout, and in Graham's case of " lipoid gout " cited above, but in paraamyloidosis with or without multiple myelomatosis, where subcutaneous ulnar nodules may also be found (Tarr and Ferris, 1939). Case 1 was, in fact, thought for a long time to be and was treated as, one of gout.…”