Case: We report the case of a 32-year-old male patient with no history of gout who developed gouty tophi encompassing retained suture material 7 years after initial repair of a ruptured Achilles tendon. The patient had a posterior ankle mass concerning for abscess. Monosodium urate crystals were identified, and uric acid level was elevated at the time of irrigation and debridement.
Conclusion: Surgical site gout is a rare but important phenomenon to recognize in the treatment of patients with Achilles tendon repairs, particularly in patients with a history of abscess, infection, or collections localized to retained suture material.
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