In reviewing these findings of McCarty and McClure, it is important to recollect that they were found in a series of cases all of which exhibited _tophi_. Moreover, it will be seen that the radiographic changes in some are reminiscent of _atrophic_ or rheumatoid arthritis, in others of _hypertrophic_ arthritis or osteoarthritis, while, lastly, the appearances typical of _infective_ arthritis are also represented. In addition, if we recall that _focal areas of rarefaction_, indistinguishable from those met with in _gout_, also occur in all types of _non-gouty_ arthritis, we at once see how impossible it is to detect anything in the _radiographic_ findings distinctive of _gouty_ as opposed to _non-gouty_ arthritides. McClure and McCarty, comparing the radiographic changes in gouty as opposed to _non-gouty_ arthritis, observe that, though _rarefactive foci_ occur in all varieties of _non-gouty_ arthritis, they are conjoined with _other bony or joint changes_. On the other hand, _translucent_ areas _unassociated with any bone or joint alterations_ have been found only in _gout_. But whether this can be claimed as distinctive of _gouty arthritis_ is, they think, uncertain, since relatively few opportunities for X-ray examination of _non-gouty_ arthritis in its _early_ stages have been forthcoming. Continuing, of their four radiographic types of gouty arthritis the second resembles osteoarthritis; but the third and especially the fourth group, they consider, “fall into a peculiar class,” this inasmuch as their characters resemble the _infective_ type of _non-gouty_ arthritis. They claim, however, that a differentiation, radiographically speaking, can be effected, this because of the “sharply localised” extreme degree of bony atrophy which occurs in the infective type of non-gouty arthritis. However, as they admit that radiographs of the latter (infective non-gouty arthritis) have been noted which “closely resemble” the “atrophic and proliferative changes occurring in gout,” their final conclusion is that in the skiagrams even of typical gouty arthritis there is nothing in the bony or arthritic changes that is _diagnostic_ of gout. For myself, I must admit that I have come to the same conclusion as McClure and McCarty, viz., that the skiagraphic findings in _gouty_ and _non-gouty_ arthritis trench so much the one upon the characters of the other that I should be loth indeed to base a diagnosis of gout simply on the revelations of _skiagraphy_. The chief interest to my mind, as I have previously observed, centres round those examples in which _peri-articular tophi_ are associated with underlying bony and arthritic changes (as revealed by X-rays) indistinguishable from those typical of _infective_ arthritis of _non-gouty_ type.