Tophi can present as a first sign of hyperuricemia but reports on the involvement of the flexor tendons of the hand is rare. Although
tuberculous tenosynovitis is a more common etiology for swelling over the wrist, gout must be among the differentials irrespective of
hyperuricemic status. Because of its low frequency, gouty involvement of the flexor tendons is not often considered in the differential diagnosis
of tenosynovitis. We report a rare case in which intratendinous tophaceous gout was found within the flexor digitorumsuperficialis tendon at
the wrist causing patient to have trigger finger like symptoms.