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After excluding infectious and neoplastic diseases, the patient was finally diagnosed with gouty shoulder arthritis. Gout affecting the bilateral shoulder joints is exceedingly uncommon, and to our knowledge, severe erosion of the glenoid has not been previously reported. When severe erosion is present, physicians and orthopedic surgeons should consider gouty shoulder arthritis according to previous medical history and clinical manifestations. Gout affecting the bilateral shoulder joints is exceedingly uncommon, and to our knowledge, se