Proximal ulnar nerve compression secondary to tophaceous gout

Although gout is a recognised but rare cause of carpal tunnel syndrome, compression of the ulnar nerve by tophaceous gout is rare. We describe a case of proximal ulnar nerve compression due to tophaceous gout in an 87-year-old man. Surgical decompression, with excision of the lesion and a section of the ulnar belly of Flexor Carpi Ulnaris produced symptomatic relief. This case illustrates that in the differential diagnosis of ulnar nerve palsy, tophaceous gout should be considered in those patients with known gout.