A 67-year-old male patient with a history of epididymectomy and anti-tuberculosis treatment for epididymis tuberculosis was admitted for acute low back pain and radiating pain. The patient had no history of gout but showed hyperuricemia and a bone destruction lesion in the facet joint and lamina of the lumbar spine. A histology examination was performed after a computed tomography-guided needle biopsy, and the findings were compatible with gout spondyloarthropathy and tuberculous spondylitis. The acute symptoms improved after conservative treatment for gouty arthritis. When patients with hyperuricemia risk factors, such as taking anti-tuberculosis drugs, complain of acute low back pain, gout spondyloarthropathy should be considered in a differential diagnosis.