ICD-10: M10.239

ICD-10 code M10.239 refers to "Drug-induced gout, unspecified wrist." Here are the clinical details and descriptions associated with this code:

• Definition: This condition is characterized by the presence of gout that is induced by certain medications. Gout is a type of arthritis caused by elevated levels of uric acid in the blood, which can lead to the formation of urate crystals in the joints and surrounding tissues, resulting in inflammation and pain.

• Symptoms: The hallmark symptoms of gout include:

• Sudden onset of joint pain, often severe.
• Swelling in the affected joint.
• Heat and redness in the area of the joint.

• The symptoms can occur suddenly and may be accompanied by fever in some cases [2].

• Affected Area: The specific designation of "unspecified wrist" indicates that the condition affects the wrist joint, but the exact location within the wrist is not specified. This can include various forms of inflammation and pain in the wrist area due to the accumulation of uric acid crystals [1].

• Related Codes: Other related ICD-10 codes for drug-induced gout include:

• M10.24 for drug-induced gout affecting the hand.
• M10.241 for drug-induced gout specifically in the right hand.

• M10.242 for drug-induced gout in the left hand [10].

• Clinical Relevance: Understanding this code is crucial for healthcare providers as it helps in the accurate diagnosis and treatment of patients experiencing gout as a side effect of certain medications. Proper coding also aids in medical billing and insurance claims [13].

In summary, M10.239 is used to classify cases of drug-induced gout affecting the wrist, highlighting the need for careful monitoring of patients on medications known to elevate uric acid levels.

ICD-10 code M10.239 refers to drug-induced gout that is unspecified and affects the wrist. The clinical presentation, signs, symptoms, and patient characteristics associated with this condition can be summarized as follows:

Clinical Presentation

• Symptoms: Patients typically experience sudden onset of joint pain, which is often severe. This pain is usually localized to the affected wrist.
• Joint Swelling: The wrist may exhibit noticeable swelling due to inflammation.
• Heat and Redness: The affected area may feel warm to the touch and appear red, indicating inflammation.

Signs

• Acute Gout Attack: The presentation often resembles an acute gout attack, characterized by intense pain and swelling.
• Limited Range of Motion: Patients may have difficulty moving the wrist due to pain and swelling.
• Tophi Formation: In chronic cases, deposits of urate crystals (tophi) may develop, although this is less common in drug-induced cases.

Patient Characteristics

• Medication History: Patients with a history of using diuretics or other medications known to precipitate gout are at higher risk. This includes drugs that can increase uric acid levels in the blood.
• Demographics: Gout can affect individuals of any age, but it is more prevalent in middle-aged men. Women are at increased risk post-menopause.
• Comorbidities: Patients may have other conditions such as hypertension, diabetes, or renal impairment, which can complicate the management of gout.

Diagnostic Criteria

To accurately use the ICD-10 code M10.239, the following criteria should be met:
- Clinical Symptoms: The patient must exhibit the characteristic symptoms of gout, including joint pain and swelling.
- Medication Review: A thorough review of the patient's medication history is essential to identify potential drug-induced causes.
- Diagnostic Tests: Laboratory tests may be conducted to measure serum uric acid levels and to rule out other causes of joint pain.

In summary, M10.239 is used to classify cases of drug-induced gout affecting the wrist, characterized by acute pain, swelling, and inflammation, often linked to specific medications that elevate uric acid levels in the body.

The ICD-10 code M10.239 refers to "Drug-induced gout, unspecified wrist, without tophus (tophi)." Here are some alternative names and related terms associated with this condition:

• Drug-induced gout: This term specifically indicates that the gout is a result of medication use.
• Chronic gout: While M10.239 specifies drug-induced gout, chronic gout is a broader term that encompasses long-term gout conditions.
• Gouty arthritis: This term refers to the inflammation of joints due to gout, which can be triggered by various factors, including drug use.
• Secondary gout: This term is used to describe gout that occurs as a result of another condition or external factor, such as medication.
• Unspecified wrist gout: This indicates that the specific joint affected is the wrist, but the exact nature of the gout is not detailed.

These terms help in understanding the context and implications of the diagnosis associated with the ICD-10 code M10.239.

The ICD-10 code M10.239 refers to "Drug-induced gout, unspecified wrist." The diagnosis of gout, particularly when it is drug-induced, typically involves several criteria, which may include:

1. Clinical Symptoms: Patients often present with sudden onset of joint pain, swelling, and redness, particularly in the affected area, which in this case is the wrist. The pain is usually severe and can be accompanied by fever.

2. Medical History: A thorough review of the patient's medical history is essential. This includes identifying any medications that may have precipitated the gout attack, such as diuretics, chemotherapy agents, or other drugs known to increase uric acid levels.

3. Laboratory Tests:
   - Serum Uric Acid Levels: Elevated levels of uric acid in the blood can support the diagnosis of gout. However, it is important to note that not all patients with high uric acid levels will have gout, and some patients with gout may have normal levels during an acute attack.
   - Synovial Fluid Analysis: If joint aspiration is performed, the analysis of synovial fluid can reveal the presence of monosodium urate crystals, which is definitive for gout.

4. Imaging Studies: X-rays or ultrasound may be used to assess joint damage or the presence of tophi (deposits of uric acid crystals) in chronic cases.

5. Exclusion of Other Conditions: It is crucial to rule out other causes of arthritis or joint pain, such as infections, other types of inflammatory arthritis, or trauma.

6. Response to Treatment: A positive response to medications that lower uric acid levels or relieve gout symptoms can also support the diagnosis.

These criteria help healthcare professionals confirm the diagnosis of drug-induced gout and ensure appropriate management and treatment.

For the treatment of drug-induced gout, particularly for the unspecified wrist (ICD10 code M10.239), standard approaches typically include the following:

• Medication Management: The primary treatment involves the use of medications to manage pain and inflammation. Commonly prescribed drugs include:
• Colchicine: Often used for acute gout attacks, it helps reduce inflammation and pain. It was noted that 48% of patients in a study used colchicine for acute episodes [3].

• Oral Corticosteroids: These are also frequently prescribed, with 38% of patients in the same study receiving them for acute gout management [3].

• Identifying and Discontinuing Triggering Medications: Since the condition is drug-induced, it is crucial to identify the specific medication causing the gout and discontinue its use if possible. This may involve collaboration with the prescribing physician to find alternative treatments for the underlying condition that does not exacerbate gout.

• Lifestyle Modifications: Patients are often advised to make lifestyle changes that can help manage gout symptoms, such as:

• Staying hydrated
• Avoiding purine-rich foods (e.g., red meats, shellfish)

• Limiting alcohol intake, particularly beer and spirits

• Monitoring and Follow-Up: Regular follow-up appointments are essential to monitor the patient's response to treatment and make necessary adjustments. This includes checking uric acid levels to ensure they are within a target range.

• Patient Education: Educating patients about the nature of gout, its triggers, and the importance of adherence to treatment plans is vital for effective management.

These approaches aim to alleviate symptoms, prevent future attacks, and manage the underlying causes of drug-induced gout effectively.