A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon

RATIONALE Gouty tophi is a rare cause of CTS. We first report a unique case of repeated CTS with gouty tophi in flexor tendon. In the previous literature, the symptoms cases of CTS were gradually increased. PATIENT CONCERNS We report a 44-year-old male porter presented with mass on his left distal forearm combined a repeated carpal tunnel syndrome for 5 years. He felt numbness in fingers and his left palmar. The CTS symptoms had been eased through rest and dugs medication. It recurred twice. DIAGNOSES Monosodium urate crystal deposits were found in surgery. Histologic findings confirmed the diagnosis of gout. INTERVENTIONS We removed partial of gouty tophus and retained the integrity of the tendon. OUTCOMES Two years after the surgery, the patient had not experienced any symptom recurrence. LESSONS Early diagnosis and control of gout are necessary to avoid irreversible complications. The surgery combined with decreasing trioxypurine treatment can improve the treatment outcome of gouty tophus.