Intraosseous gouty tophus as the cause of pathological fracture is a seldom encountered condition. Not only does the tophus lesion affect the bone, but recent literature has also demonstrated a correlation between bone health in relation to gout as a disease entity, and showed the importance of medical treatment to improve the bone quality in patients with gout. We present a rare case of a pathological fracture due to an intraosseous gouty tophus as the presentation of gout, which imposed a diagnostic challenge, and illustrates the importance of multidisciplinary management in such conditions.
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