Posterior interosseous nerve compressive neuropathy due to gouty tophi: a case report and literature review

Gout is a metabolic disorder characterized by the deposition of monosodium urate crystals in joints and soft tissues, which may lead to the formation of gouty tophi in chronic cases. We report a rare case of posterior interosseous nerve palsy caused by compression from gouty tophi in the elbow region. The patient underwent surgical decompression and excision of the tophi, with subsequent full recovery of finger extension. This case highlights that gouty tophi, though rare, can be a treatable cause of posterior interosseous nerve neuropathy. Tophaceous gout should be included in the differential diagnosis when evaluating unexplained motor deficits, especially in patients with a history of gout or risk factors for hyperuricemia.