ICD-10: M10.272

ICD-10 code M10.272 refers specifically to "Drug-induced gout, left ankle and foot." This classification falls under the broader category of gout, which is a type of inflammatory arthritis characterized by sudden and severe pain, redness, and swelling in the joints. Here’s a detailed overview of this condition, its clinical description, and relevant details.

Clinical Description of Drug-Induced Gout

What is Gout?

Gout is a form of arthritis that occurs when there is an excess of uric acid in the blood, leading to the formation of urate crystals in the joints. This condition can cause intense pain and inflammation, often affecting the big toe but can also impact other joints, including the ankle and foot.

Drug-Induced Gout

Drug-induced gout occurs when certain medications lead to elevated uric acid levels in the body, triggering gout attacks. Common medications that may induce gout include:

• Diuretics: Often prescribed for hypertension or edema, these can increase uric acid levels by promoting its retention.
• Chemotherapy agents: Some cancer treatments can lead to rapid cell turnover, releasing purines that convert to uric acid.
• Aspirin: Low doses of aspirin can interfere with uric acid excretion, potentially leading to gout.

Symptoms

The symptoms of drug-induced gout are similar to those of primary gout and may include:

• Severe pain: Often sudden and intense, typically occurring at night.
• Swelling and redness: Affected joints, such as the left ankle and foot, may appear swollen and red.
• Limited range of motion: Pain can restrict movement in the affected joint.

Diagnosis and Treatment

Diagnosis

Diagnosis of drug-induced gout typically involves:

• Clinical evaluation: A healthcare provider will assess symptoms and medical history, including medication use.
• Blood tests: These can measure uric acid levels, although normal levels do not rule out gout.
• Joint fluid analysis: A sample may be taken from the affected joint to check for urate crystals.

Treatment

Management of drug-induced gout focuses on relieving symptoms and addressing the underlying cause:

• Medication adjustment: If a specific drug is identified as the cause, a healthcare provider may recommend alternative treatments.
• Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids can help reduce pain and inflammation.
• Lifestyle modifications: Dietary changes, hydration, and weight management can also play a role in managing uric acid levels.

Conclusion

ICD-10 code M10.272 is crucial for accurately documenting cases of drug-induced gout affecting the left ankle and foot. Understanding the clinical implications, symptoms, and treatment options is essential for effective management of this condition. If you suspect drug-induced gout, consulting a healthcare professional for a thorough evaluation and tailored treatment plan is advisable.

The ICD-10 code M10.272 refers specifically to drug-induced gout affecting the left ankle and foot. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation of Drug-Induced Gout

Drug-induced gout occurs when certain medications lead to elevated levels of uric acid in the blood, resulting in the formation of urate crystals in the joints. This condition can manifest in various ways, particularly affecting the lower extremities, such as the ankle and foot.

Signs and Symptoms

1. Acute Pain: Patients typically experience sudden and severe pain in the affected joint, often described as throbbing or excruciating. The left ankle and foot are specifically involved in this case, leading to localized discomfort[1].

2. Swelling and Inflammation: The affected area may become swollen, red, and warm to the touch. This inflammation is a direct response to the presence of urate crystals in the joint space[2].

3. Limited Range of Motion: Due to pain and swelling, patients may find it difficult to move the affected joint, leading to decreased mobility and functional impairment[3].

4. Tophi Formation: In chronic cases, patients may develop tophi, which are deposits of urate crystals that can form under the skin around joints, although this is less common in acute drug-induced cases[4].

5. Fever and Malaise: Some patients may experience systemic symptoms such as fever, chills, and a general feeling of unwellness, particularly during acute flare-ups[5].

Patient Characteristics

1. Medication History: A key characteristic of patients with drug-induced gout is a history of medications known to elevate uric acid levels. Common culprits include diuretics, certain chemotherapy agents, and medications used to treat hypertension[6].

2. Demographics: Gout is more prevalent in males than females, particularly in middle-aged individuals. However, drug-induced gout can also affect women, especially those on specific medications[7].

3. Comorbid Conditions: Patients may have underlying conditions such as hypertension, diabetes, or renal impairment, which can influence uric acid metabolism and exacerbate gout symptoms[8].

4. Lifestyle Factors: Dietary habits, alcohol consumption, and obesity can also play a role in the development of gout. Patients with a high-purine diet or those who consume alcohol excessively may be at increased risk, even when taking medications that induce gout[9].

5. Genetic Predisposition: A family history of gout may increase the likelihood of developing the condition, particularly when combined with drug exposure[10].

Conclusion

Drug-induced gout, particularly affecting the left ankle and foot as indicated by ICD-10 code M10.272, presents with acute pain, swelling, and inflammation in the affected joint. Understanding the signs, symptoms, and patient characteristics is essential for healthcare providers to diagnose and manage this condition effectively. Identifying the offending medication and addressing lifestyle factors can significantly improve patient outcomes and reduce the frequency of gout attacks. Regular monitoring and patient education about medication side effects are also critical components of managing drug-induced gout.

ICD-10 code M10.272 specifically refers to "Drug-induced gout, left ankle and foot." Understanding alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some alternative names and related terms associated with this diagnosis.

Alternative Names

1. Medication-Induced Gout: This term emphasizes that the gout is a result of medication use.
2. Pharmacological Gout: A more technical term that indicates the condition arises from pharmacological agents.
3. Drug-Related Gout: This term highlights the connection between drug use and the onset of gout symptoms.

Related Terms

1. Gout: A general term for a type of arthritis characterized by sudden, severe attacks of pain, swelling, and redness, often affecting the big toe but can also affect other joints.
2. Hyperuricemia: A condition of elevated uric acid levels in the blood, which can lead to gout.
3. Uric Acid Nephrolithiasis: Kidney stones formed from uric acid, which can be a complication of gout.
4. Ankle Gout: A more specific term that refers to gout affecting the ankle joint, which is relevant in the context of M10.272.
5. Foot Gout: Similar to ankle gout, this term refers to gout affecting the foot, relevant for the same ICD-10 code.

Clinical Context

Drug-induced gout can occur due to various medications, including diuretics, certain chemotherapy agents, and medications that affect uric acid metabolism. Recognizing these alternative names and related terms can aid healthcare professionals in accurately diagnosing and treating patients with this condition.

In summary, while M10.272 specifically denotes drug-induced gout in the left ankle and foot, understanding its alternative names and related terms can facilitate better communication and documentation in clinical settings.

To diagnose drug-induced gout, specifically coded as ICD-10 code M10.272, which refers to gout affecting the left ankle and foot, healthcare providers typically follow a set of established criteria. These criteria help ensure accurate diagnosis and appropriate treatment. Below is a detailed overview of the diagnostic criteria and considerations for this specific condition.

Understanding Drug-Induced Gout

Gout is a type of inflammatory arthritis characterized by the accumulation of uric acid crystals in the joints, leading to sudden and severe pain, redness, and swelling. Drug-induced gout occurs when certain medications elevate uric acid levels in the body, triggering gout attacks. Common medications associated with this condition include diuretics, certain chemotherapy agents, and immunosuppressants.

Diagnostic Criteria for Drug-Induced Gout

1. Clinical Presentation

• Symptoms: Patients typically present with acute onset of joint pain, often described as excruciating. The affected joint (in this case, the left ankle and foot) may appear swollen, red, and warm to the touch.
• Duration: Symptoms usually last for a few days to weeks, with potential for recurrent episodes.

2. Medical History

• Medication Review: A thorough review of the patient's medication history is crucial. Identification of drugs known to increase uric acid levels is essential. Common culprits include:
• Diuretics (e.g., thiazides)
• Aspirin (low doses)
• Certain chemotherapy drugs (e.g., cytarabine)
• Immunosuppressants (e.g., cyclosporine) [1][2].

3. Laboratory Tests

• Serum Uric Acid Levels: Elevated serum uric acid levels (hyperuricemia) are indicative of gout. However, it is important to note that not all patients with high uric acid levels will develop gout.
• Synovial Fluid Analysis: Aspiration of the affected joint may be performed to analyze synovial fluid. The presence of monosodium urate crystals confirms the diagnosis of gout.
• Inflammatory Markers: Blood tests may also show elevated inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) [3].

4. Exclusion of Other Conditions

• Differential Diagnosis: It is important to rule out other causes of joint pain and swelling, such as infections, other types of arthritis (e.g., rheumatoid arthritis), or pseudogout. This may involve imaging studies or additional laboratory tests.

5. Response to Treatment

• Therapeutic Trial: A positive response to gout-specific treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, or corticosteroids, can further support the diagnosis of gout.

Conclusion

Diagnosing drug-induced gout, particularly in the left ankle and foot, involves a comprehensive approach that includes clinical evaluation, medication history, laboratory tests, and exclusion of other conditions. Accurate diagnosis is essential for effective management and prevention of future gout attacks. If you suspect drug-induced gout, it is advisable to consult a healthcare professional for a thorough assessment and appropriate treatment options.

References

1. ICD-10-CM Codes M10*: Gout.
2. Rheumatology ICD-10 Codes & Classifications.
3. ICD-10 International Statistical Classification of Diseases.

Drug-induced gout, classified under ICD-10 code M10.272, refers to gout that arises as a side effect of certain medications. This condition typically manifests with acute inflammation and pain in the affected joints, in this case, the left ankle and foot. Understanding the standard treatment approaches for this condition is crucial for effective management and relief of symptoms.

Understanding Drug-Induced Gout

Gout is a type of inflammatory arthritis characterized by the accumulation of uric acid crystals in the joints, leading to intense pain and swelling. Drug-induced gout can occur due to medications that either increase uric acid levels or interfere with its excretion. Common culprits include diuretics, certain chemotherapy agents, and medications used to treat hypertension and heart conditions[1].

Standard Treatment Approaches

1. Medication Adjustment

The first step in managing drug-induced gout is to review and potentially adjust the medications that may be contributing to elevated uric acid levels. This may involve:

• Discontinuation or substitution: If a specific medication is identified as the cause, healthcare providers may consider discontinuing it or switching to an alternative that has a lower risk of inducing gout[2].
• Consultation with specialists: In some cases, a consultation with a rheumatologist or a specialist in pharmacology may be warranted to find suitable alternatives.

2. Acute Gout Attack Management

For patients experiencing an acute gout attack, the following treatments are commonly employed:

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen are often prescribed to reduce pain and inflammation during an acute episode[3].
• Colchicine: This medication can be effective in treating acute gout attacks, especially if administered early in the course of the attack[4].
• Corticosteroids: In cases where NSAIDs or colchicine are contraindicated or ineffective, corticosteroids may be used to control inflammation and pain[5].

3. Long-term Management

To prevent future gout attacks and manage uric acid levels, long-term strategies may include:

• Urate-lowering therapy: Medications such as allopurinol or febuxostat can help lower uric acid levels in the blood, reducing the risk of future attacks[6].
• Lifestyle modifications: Patients are often advised to make dietary changes, such as reducing intake of purine-rich foods (e.g., red meat, shellfish) and alcohol, which can exacerbate gout symptoms[7].
• Hydration: Increasing fluid intake can help dilute uric acid levels and promote its excretion through the kidneys[8].

4. Monitoring and Follow-up

Regular follow-up appointments are essential to monitor uric acid levels and assess the effectiveness of treatment strategies. Adjustments to medication dosages or treatment plans may be necessary based on the patient's response and any side effects experienced[9].

Conclusion

Managing drug-induced gout, particularly in the left ankle and foot, requires a comprehensive approach that includes medication review, acute management of symptoms, long-term urate-lowering strategies, and lifestyle modifications. By addressing both the immediate symptoms and the underlying causes, healthcare providers can help patients achieve better control over their condition and improve their quality of life. Regular monitoring and adjustments to treatment plans are vital to ensure optimal outcomes and prevent recurrence of gout attacks.