Tophaceous gout of the spine: Expansile mass with mass effect at L4–5

Abstract Gout is one of the most common inflammatory arthropathies in the world. However, spinal involvement is relatively rare, and other menacing differential diagnoses should be considered. Our report describes the case of a 64-year-old female with a complex medical history who was initially thought to have an infectious or malignant etiology, but further testing confirmed gouty arthropathy. The early recognition of imaging findings can prevent delayed or inappropriate medical treatment. The following core competencies are addressed in this article: Patient care, Medical knowledge, Practice-based learning and improvement, and Systems-based practice.