Chronic tophaceous gout is a common metabolic disorder in older people, and although spinal involvement is rare, it can mimic other disease processes [1]. Spinal gout can present with back pain, lytic vertebral lesions or neurological compromise.An 82-year-old man was admitted with a 15-kg weight loss and 3 months of increasing back pain. He had multiple gouty tophi on both hands. Radiology demonstrated lucent spinal lesions which were initially thought to represent multiple myeloma or metastases. Tissue diagnosis confirmed spinal gout.
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