Study Design: Case report.Objective: We report a case of a 16-year-old boy with intermittent and migratory polyarthralgia, who made a diagnostic dilemma.Summary Of Background Data: Spinal involvement without spinal symptom in gout seems to be rare. However, the relationship of spinal gout to symptoms is poorly understood.Methods: Description of the case report.Results: Laboratory findings cannot explain his symptoms; however, a computed tomography of the pelvis revealed the presence of space-occupying lesion involving the left side of spine at L5-S1 level, and the later biopsy revealed that was a urate crystal, which help us make the diagnosis of spinal gout.Conclusion: Gout can be a cunning disease which has various manifestations, and spinal involvement can be asymptomatic.Level Of Evidence: 5. [ABSTRACT FROM AUTHOR]