Gouty arthritis. ICD gouty arthritis Gouty arthritis by ICD

Sealants 04.01.2021

When a person notices certain symptoms in himself, he almost immediately runs to the clinic. After passing the diagnostics and passing tests, the doctor makes a diagnosis - rheumatoid arthritis.

In general, disease activity begins about a year or two after its onset. The disease is characterized by the manifestation of general symptoms, such as inflammation in the joints and discomfort in the morning.

But rheumatoid arthritis is a disease that has many subtypes.

Classification according to ICD-10

According to the International Classification of Diseases 10 revision, rheumatoid arthritis is seropositive and seronegative. These two species also have their own classification and each subspecies of the disease has its own code.

Seronegative RA, ICD-10 code - M-06.0:

Still's disease in adults - M-06.1;
bursitis - M-06.2;
rheumatoid nodule - M-06.3;
inflammatory polyarthropathy - M-06.4;
other specified RA - M-06.8;
seronegative RA, unspecified - M-06.9.

Seropositive RA, ICD-10 code - M-05:

Felty's syndrome - M-05.0;
rheumatoid lung disease - M-05.1;
vasculitis - M-05.2;
rheumatoid arthritis involving other organs and systems - M-05.3;
other seropositive RA - M-05.8;
unspecified RA - M-05.9.

Historical development of rheumatoid arthritis

History says that arthritis and similar diseases were known to our ancestors.

The history of ancient times refers to Papyrus Ebers as the first person to name a medical condition that is similar to rheumatoid arthritis.

The history of Egypt indicates that rheumatoid arthritis was the leading disease in this country.

The history of India names the symptoms by which the disease can be identified: painful manifestations, swelling and restriction in movement.

1858 story: B Garrod names the causes that distinguish rheumatoid arthritis, osteoarthritis, and gout.

History of the Far East: in case of illness, acupuncture is used as a treatment.

History of 1880: the publication known at that time determines the chronic course of the disease, the effect on the tendon sheath, and the inflammatory process.

The famous figure Hippocrates used willow extracts to relieve pain in case of illness.

1929 story: Leroux names salicylic acid as a remedy for arthritis pain.

Diagnosis of the disease

The definition and diagnosis of the disease is made on the basis of indicators such as criteria for rheumatoid arthritis. These include:

discomfort in the joints and periarticular tissues after sleep, which is typical in the morning. As a rule, the activity of such pains lasts for one hour;
arthritis activity is manifested in three or more joint areas;
the disease is characteristic of the joints in the hands. There is a tumor process in one of the joints: radiocarpal, metacarpophalangeal, proximal interphalangeal;
symmetrical form of the disease. The inflammatory process begins in similar articular areas on both sides.
the occurrence of rheumatoid nodules;
clinical tests reveal the presence of rheumatoid factor in the blood;
the presence of changes in the radiographic image: erosion.

The diagnosis of the disease is considered confirmed in the case of identified four symptoms of the above, the activity of which should be observed for six weeks.

Tests to help clarify the diagnosis

As a rule, when diagnosing a disease, the doctor prescribes the following tests:

Laboratory tests that contribute to the correct diagnosis. clinical analyses. These include a clinical blood test, which helps to find out how much hemoglobin is reduced in the patient's body.

Clinical tests are not a decisive link in the diagnosis, but thanks to them it is possible to determine how difficult the course of the disease is.

biochemical analyses. These include a biochemical blood test that can determine the presence or absence of rheumatoid factor and C-reactive protein.

Determination of the erythrocyte sedimentation rate. The speed is normal and high. Increased speed means that in the human body there is an inflammatory process, an exacerbation of the disease or a severe course.

X-ray examination. When the disease is just beginning, the x-ray will not show any visible changes. You can only notice excess joint fluid and swelling. But such symptoms are not only X-rays and tests that can show. They can be seen with a direct examination by a doctor. With the active development of arthritis, an x-ray will be able to show the presence of specific signs: erosion, reduction of joint spaces, ankylosis.

Analysis for the presence of antibodies to the cyclic peptide. Such an analysis is the most reliable in modern medicine. Thanks to him, rheumatoid arthritis can be detected in 80% of cases of diagnosis.

Juvenile (juvenile) type of rheumatoid arthritis

Juvenile type of rheumatoid arthritis is a rheumatic disease that appears before the age of 16 years of a child (adolescent).

As a rule, in medicine there is no unequivocal answer why a disease occurs. At risk are people with a genetic predisposition.

The juvenile type of rheumatoid arthritis has the following manifestations, such as swelling in the joints, a feeling of stiffness, pain, and it is also noticed that the disease affects the eyes.

There is a feeling of photophobia, conjunctival infections, glaucoma, keratopathy. The juvenile type of rheumatoid arthritis manifests itself with an increase in temperature.

Diagnosis of the disease includes all the same methods applied to adult patients.

As a rule, in case of adequate treatment, juvenile type of rheumatoid arthritis can be defeated in 50% of cases. How long it will take for treatment, and what drugs to take, only the attending physician can determine.

Biological agents as a way of treatment

Biological agents are proteins that are genetically engineered. Based on human genes.

This method of treatment is aimed at suppressing inflammation in the disease. What are the differences between biological agents, while not forming side effects? Proteins act on a number of specific components of human immunity, while excluding further complications.

Despite fewer side effects, they are still available. So, there is an increase in body temperature, the occurrence of infectious diseases. In addition to such mild side effects, an exacerbation of an existing chronic disease is possible.

There is not so much a recommendation as a ban on the use of biological agents in case of sclerosis, chronic heart failure. The use of such agents should only be in the presence of a physician. Application is carried out by intravenous administration. It is forbidden to administer the drug during pregnancy.

Disability in rheumatoid arthritis

Disability is established taking into account the following factors:

the degree of the disease;
course of the disease;
existing exacerbations and remissions during the last year;
lead doctor's prognosis;
the patient's ability to provide for himself.

Disability in the disease has two subsections: disability from childhood (before adulthood) and general disability (after adulthood).

There are 3 groups of disability:

It is used for mild or moderate disease. A person can serve himself, move around.
Placed in the moderate or severe course of the disease. A person requires care, can partially serve himself, mobility is limited.
Placed in severe illness. There is no independent movement. Man cannot take care of himself. Requires constant care.

Psychosomatics

The psychosomatics of the disease determines the interaction of rheumatoid arthritis (ICD-10 code) with psychological state sick. So, the mental influence on the course of the disease can completely change it.

In the case of different disorders, psychosomatics will also be different. That is why an individual psychological diagnosis is required.

Psychosomatics is characterized by the following factors, such as the feeling that a person is the center of all affairs and concerns, and in childhood such people are brought up in certain ways. They are characterized by super-conscientiousness and external compliance, self-sacrifice and excessive need for physical exertion.

Psychosomatics is one of the main reasons for the development of the disease.

Medical treatment for rheumatoid arthritis

What drugs does the doctor prescribe for the treatment of the disease? As a rule, the use of traditional anti-inflammatory drugs helps to reduce pain, swelling, and increase the functioning of the joints.

How much drug is required to treat rheumatoid arthritis? As a rule, a reduced dose is used.

It is also possible to use analgesics, which also help to eliminate pain.

Common medicines in the treatment of arthritis

Today, medicine has a lot medicines contributing to the treatment of rheumatoid arthritis (ICD-10 code). These include:

Sulfasalazine

Sulfasalazine in some American countries prohibited from use. In our country, Sulfasalazine is the safest remedy that can slow down the development of the disease.

It should be noted that Sulfasalazine can cause a number of side effects. So, it is forbidden to use the drug Sulfasalazine with individual intolerance.

As a rule, Sulfasalazine is started at 500 mg / day, and after 14 days the dose is increased. The maintenance dose of the drug is 2 g / day.

Sulfasalazine is divided into two doses per day. For children, Sulfasalazine is divided into four doses.

As a rule, the effectiveness of the drug Sulfasalazine comes to the beginning - the end of the third month of treatment. Sulfasalazine can cause the following negative effects: the manifestation of nausea, loss of appetite, agranulocytosis.

Methotrexate

Methotrexate is widely used in oncology. So, thanks to him, inhibition of the division of cancer cells occurs. But methotrexate has found its use in rheumatoid arthritis.

Only a doctor is able to prescribe the correct dosage of Methotrexate.

Basically, Methotrexate leads to improvement 6 months after its use. It must be remembered that the frequency of taking the drug Methotrexate contributes to rapid treatment.

Wobenzym

Wobenzym helps to reduce side effects, as well as reducing the dosage of basic drugs. Wobenzym also helps to reduce the dosage of non-steroidal anti-inflammatory drugs.

The drug Wobenzym can be prescribed by a doctor with a mild degree of the disease. Wobenzym is also prescribed for contraindications to immunosuppressive therapy.

Metipred

Metipred belongs to the group of corticosteroids. In other words, Metipred is referred to as methylprednisolone.

In the case of rheumatoid arthritis, Metipred helps to eliminate painful manifestations, as well as improve the general condition of the disease.

Metipred has its own side effects. That is why it is necessary to use this drug as directed by a doctor.

Turmeric

Turmeric is not a medicine at all, but rather a folk method of treatment.

Turmeric is popularly known as a seasoning for many dishes. In addition to this property, turmeric is famous for its medicinal properties. So, turmeric helps to relieve painful manifestations, as well as swelling on the inflamed joint.

Preparing a healing mixture is not at all difficult. To do this, you need to mix chopped turmeric and olive oil. Miracle mix to use in the amount of 2 teaspoons with food.

Turmeric is useful as a seasoning that must be added to food at least 2 times in 7 days.

And most important rule- Unauthorized treatment will only aggravate the course of the disease.

2016-11-29

Gouty arthritis ICD code 10

A disease that develops due to the deposition of uric acid salts in the joints and organs. This happens when metabolism is disturbed in the human body and uric acid crystals (or urates) are deposited in the kidneys and joints. This leads to inflammation, difficulty in movement, and deformation of the joint. The kidneys also suffer, in which crystals are deposited, which disrupts the normal functioning of the excretory system. There is a classification of diseases, which lists all the names and categorized by development, treatment, clinical picture. This classification is called ICD ( international classification diseases). Gouty arthritis ranks under the name ICD 10.

Gout and gouty arthritis and their place in ICD 10

When the patient comes to medical institution, and he is diagnosed with gouty arthritis, ICD code 10, and they write it on a card. This is done so that the doctors and the rest of the staff understand what the patient's diagnosis is. All diseases according to the ICD classification are clearly divided into their groups and subgroups, where they are indicated by letters of the alphabet and numbers, respectively. Each group of diseases has its own designation.

Also, there are generally accepted norms of therapy, as a single main criterion, tactics or method of treatment that is prescribed to all patients with a particular disease. Further, judging by the patient's condition, the development of the disease or other concomitant pathologies, he is prescribed symptomatic therapy.

The entire classification of diseases of the musculoskeletal system in the ICD is located under the letter M, and each type of such pathology is assigned its own number from M00 to M99. Gouty arthritis in the ICD is in place of M10, in which there are subgroups with designations various kinds specifically gouty arthritis. This includes:

Gout, unspecified
Gout associated with impaired renal function
Medicinal
Secondary
lead
idiopathic

When a patient contacts a medical institution, a detailed history is taken, laboratory (analyzes) and instrumental methods (X-ray, ultrasound, and so on) study the disease. After an accurate diagnosis, the doctor sets the ICD 10 code and prescribes the appropriate treatment and symptomatic therapy.

Cause of gouty arthritis according to ICD 10

It has been proven that gouty arthritis most often affects men and only at the age, and women, if they get sick, only after menopause. Young people are not exposed to the disease due to the fact that hormones, of which a sufficient amount is released in young people, are able to remove uric acid salts from the body, which does not allow crystals to linger and settle in the organs. With age, the amount of hormones decreases due to the inhibition of certain body processes and the process of removing uric acid no longer proceeds as intensively as before.

But, nevertheless, until now, scientists cannot accurately name the reason why gouty arthritis occurs. According to statistics and the study of the disease, risk factors are identified that can give impetus to the development of the pathological process of accumulation of uric acid in organs. These are risk factors such as:

Heredity. Many types of chronic inflammatory joint pathologies are inherited. It may be that the disease does not manifest itself in a person’s entire life, but this is extremely rare.
Diseases are precursors. Renal pathologies, heart disease, hormonal disorders.
Incorrect or inadequate nutrition. Abuse of meat or offal, strong tea and coffee, alcohol, chocolate.
Long-term use of certain medications. Such as means for lowering pressure, cytostatic and diuretic.

In addition, there are primary and secondary gout. Primary occurs when a combination of genetic heredity and the use of large quantities of unwanted products. Secondary develops with cardiovascular diseases, hormonal disorders and medications. The difference in the occurrence of the disease does not affect clinical picture manifestations of symptoms, the whole point is how exactly gouty arthritis developed, which organs and mechanisms it affected, in order to assess at what stage the pathological process is. If necessary, explain to the patient why the disease began, and how exactly to correct the lifestyle in order to remove an additional factor provoking the disease.

Classification of the disease in ICD 10

There is a large variety of gouty arthritis in connection with clinical symptoms, the pathogenesis of the disease, the mechanism of uric acid deposition, the manifestation of articular forms of gouty arthritis.

Primary and secondary gout differ in the mechanism of development of the disease. According to the different mechanism of accumulation of uric acid crystals, gout can be of different types:

hypoexcretory;
Metabolic;
Mixed type.

According to the clinical picture of the course of gouty arthritis, it differs:

Asymptomatic manifestations of the disease;
Acute form of gouty arthritis;
Development of tophi;
Pathologies of the kidneys that have developed against the background of gout.

According to the manifestation of articular forms, there are:

acute form;
Intermittent form;
The chronic form is manifested by the deposition of tophi.

Gouty arthritis and its other types and manifestations are listed in ICD 10 and each form of the disease is assigned its own, personal number.

Gouty arthritis and its clinical manifestations

The disease has one peculiar negative quality, which lies in the fact that the accumulation of uric acid crystals can occur unnoticed by the patient. Gouty arthritis does not show any symptoms, there is no clinical picture, but if there is a strong stressful situation, a serious illness, this can give impetus to the development of the disease. In this regard, a rather vivid clinical picture develops, since the amount of deposited uric acid in the organs is large and gouty arthritis, as it were, “is on pause” and is waiting for the moment for rapid development.

There are three stages of the disease, differing in the number of symptoms and the severity of the course.

Gouty arthritis does not affect large joints, being localized in small ones. Most often it is the joints of the legs and hands. In 9 out of 10 cases, the joint of the big toe is affected first. The first manifestations of the disease are always pronounced and the person begins to worry and seek help from a medical institution.

During a vivid pathological process, the symptoms are extremely specific. There are severe pain, inflammation, swelling, redness, fever at the site of the joint. Uric acid crystals are deposited in the cavity and on the surface of the joint, as well as under the skin. If the course of an acute attack is long, then the decaying tissues of the joint, together with uric acid, form tophi (nodules). In places where there is no joint tissue, it is replaced by urates, which leads to a decrease in functioning and to a strong modification of the limb. Gradually, the joint becomes unable to do its job and the person becomes disabled.

In women, the gouty form rarely causes such strong changes in the joint, even less often tophi are formed, so the disease does not cause significant deformity and loss of joint function. In men, on the contrary, the gouty form is extremely aggressive and if no measures are taken to eliminate the disease, the person becomes disabled.

Diagnostics

Hyperurinemia in a laboratory blood test is not a reliable sign confirming gouty arthritis. This may indicate a metabolic disorder in the body and not manifest itself in the articular form. During an acute attack, a joint (or tophi, if any) is punctured and the material obtained is analyzed in the laboratory, in which white crystalline deposits of uric acid are found.

When an attack of gouty arthritis occurs, it is quite difficult to determine what kind of inflammatory process is present at the moment. Since the symptoms are similar to other chronic diseases of the articular tissue.

X-ray examination, with a long course of an acute attack, makes it possible to differentiate the pathology in connection with the detection of joint destruction on the radiograph, the presence of punches (places where the joint tissue has undergone decay).

Basic Treatments

There are three main areas, according to ICD 10:

Medical. NSAIDs are prescribed to reduce pain and inflammation, glucocorticoids - regulate the hormonal background of the body, colchicine - lowers the temperature, stops the processes of crystallization of uric acid and its production, which significantly affects the inflammatory process already at an early stage of an attack of gouty arthritis.
Physiotherapy. Treatment is aimed at local reduction of inflammation, pain, swelling and temperature. Methods such as electrophoresis medicines allow the drug to locally penetrate into the tissues and intensively perform its work. Applications to the site of injury (for example, using dimexide) also increase the chances of a speedy recovery and getting rid of a number of symptoms during an acute attack.
exercise therapy. It is aimed at improving the mobility of the articular apparatus and the restoration of partially lost mobility due to the combination of a drug treatment method, physiotherapy and physical education. Special exercises have been developed that allow you to gradually increase the load during classes, which over time makes it possible to fully restore all lost functions.

For example, foot exercises:

Prevention and prognosis of the disease

Gouty arthritis can be prevented, it is enough to monitor your diet, limit alcohol consumption to acceptable doses. Exercise or do daily activities morning exercises. It's quite simple, but effective.

The prognosis is quite positive, but only on the condition that the patient makes a lifestyle correction, which will prevent the manifestation of acute attacks of the disease and reduce it to a long period of remission.

Outcome

Gouty arthritis according to ICD10 is a systemic disease associated with metabolic disorders. This can be avoided if you monitor your health, nutrition and moderate physical activity on the body.

general information
Symptoms
Diagnosis of the disease
Treatment

Arthritis is a chronic inflammatory joint disease. There are several types of arthritis - reactive, rheumatoid arthritis, also gouty, osteoarthritis, septic and juvenile arthritis, spondylitis. In this case, let's talk about rheumatoid arthritis.

general information

Rheumatoid arthritis mostly affects the knees, feet, hips, shoulders, arms, wrists, and elbows, and the inflammation is symmetrical. Inflammation of the joints occurs due to damage to the membrane membrane that lines the surface of the joints. In progress, the cartilaginous bone is affected, the joints are deformed, and the bone tissue is eroded.

In rare cases, rheumatoid arthritis affects the lungs, heart, and nervous system.

The causes of the disease are not fully understood, it is believed that genetic heredity plays the main role here. It is reliably known that this is an autoimmune disease, when the body synthesizes antibodies against its own membrane shell.

According to the international classification of diseases of the 10th revision (ICD-10), there is the following differentiation of the disease:

M05 - Seropositive RA;
M06 - Other RA;
M05.0 - Felty's syndrome;
M05.1 - Rheumatoid lung disease;
M05.2 - vasculitis;
M05.3 - RA with damage to a number of organs;
M06.0 - Seronegative RA;
M06.1 - Still's disease in adults;
M06.9 - RA of unknown origin.

This disease affects about 2% of the population, regardless of race. And in women, arthritis occurs 3-4 times more often than in men. At any age there is a risk of getting, no matter what the cause, rheumatoid arthritis, and it is quite common in young people and in children. The disease is very complex, and disability threatens 70% of all cases, and due to a number of complications, such as infections and kidney failure, it can be fatal.

Symptoms.

Rheumatoid arthritis is inseparable from chronic polyarthritis, i.e. inflammation of several joints at the same time. Gradually, patients begin to observe fatigue, weakness in the muscles. The first signs can be observed for several weeks, until the inflammation becomes more than obvious. Symptoms increase gradually as inflammation increases. What can be the main signs.

Rheumatoid arthritis can be distinguished by joint stiffness, especially due to prolonged immobility of the body. Usually this condition occurs after sleep and passes after an hour or more. How long the stiffness lasts, so much and a serious degree of inflammation is present. With inflammation of the joints, pain, swelling of the joint, fever in the area of \u200b\u200binflammation can be felt.

For any of the above signs, a doctor's consultation is necessary to make a diagnosis, the doctor will determine the prognosis for the further course of the disease and methods of treatment. So, to summarize the main signs: fatigue is felt, there is no appetite, unusual pain in the joints, general weakness of the body. Pay special attention to these symptoms if someone in your family is ill or has had the disease in the past. If you know that you have arthritis, but you notice pain, swelling of the joints, discomfort in the stomach, immediately consult a doctor to correct the treatment.

Diagnosis of the disease

To make a correct diagnosis, it is necessary to present the whole picture of the disease as a whole, taking into account the patient's medical history. It will not be possible to reliably establish signs of rheumatoid arthritis with a laboratory method. The very presence of rheumatoid factor in the blood does not indicate the presence of this disease, but may indicate the presence of another serious illness. As a result of a blood test, we can say that rheumatoid arthritis is directly related to the presence of anemia in a patient.

Radiological signs of rheumatoid arthritis are not always obvious and it is not possible to make an accurate diagnosis. X-rays will help to identify swelling of the tissues near the joint, as well as the presence of fluid. Detection of bone erosion at an early stage indicates the progression of rheumatoid arthritis and requires immediate treatment. As the disease progresses, disorders in the structure of the joints become more noticeable, there is a narrowing of the space between the joints and the destruction of bone tissue.

Treatment

Treatment for rheumatoid arthritis is aimed at suppressing the activity of the process, relieving pain, reducing stiffness in the joints and preventing complications. To facilitate overcoming the disease, considerable attention should be paid to nutrition. It has been proven that some foods contribute to the complication of the disease. Therefore, the diet should exclude the use of fatty meat, milk, citrus, oatmeal and rye cereals, corn. Positive effect will be from eating vegetarian low-calorie foods.

How to cure arthritis medications the doctor knows, you can’t prescribe any medicines on your own if they became known only on the recommendation of people without medical education, according to reviews on any forum or site.

Basic therapy includes taking non-steroidal anti-inflammatory drugs: Meloxicam, Diclofenac, Nimesulide, Dexalgin. They have anti-inflammatory and analgesic effects. In addition, glucocorticoids, such as prednisolone, are used. These drugs should be used with caution, as the risk of developing unwanted manifestations is quite high. So, NSAIDs negatively affect the gastrointestinal tract and the occurrence of ulcers. Glucocorticoids adversely affect the immune system, triggering autoimmune processes, destroy bones, cause diabetes and obesity, and exacerbate existing chronic diseases.

To reduce the activity of the rheumatoid process, it is recommended to take drugs: Methotrexate, D-penicillamine, Azathioprine, Sulfasalazine, Cyclophosphamide. They work to suppress the immune system, thereby slowing down the destruction of bones with their own protective potential. Therefore, patients when taking these drugs are extremely susceptible to various kinds of infections. I must say that the drugs of this group are very toxic, affect the blood, affect a number of internal organs. They should be taken with extreme caution and only after a doctor's prescription, if really necessary.

Modern treatment of rheumatoid arthritis is still not complete without physiotherapy. The patient is prescribed ultraviolet irradiation, magnetotherapy, electrophoresis with anti-inflammatory drugs. When the acute stage of the disease subsides, it is recommended to supplement the treatment with massage and exercise therapy.

Gouty arthritis is one of the diseases associated with metabolic disorders. Pathology is characterized by an increase in uric acid in the blood. In another way, this condition is called hyperuricemia and is characterized by the deposition of urates, oxalates in the tissues of the joint.

As a result, the mobility of the joint is lost, and each movement is accompanied by acute pain.

Etiology of the disease

The onset of the disease is considered the first recorded attack of gouty arthritis. However, this condition is often preceded by asymptomatic hyperuricemia (premorbid period).

At the same time, the volume of uric acid in the blood exceeds the norm, but the deposition of salts in the joints does not yet occur.

When a certain critical indicator is reached, uric acid gradually crystallizes, which leads to the formation of oxalates and urates. This condition is called acute gouty arthritis, which occurs with severe pain, impaired joint mobility, inflammation, and swelling.

The main feature of the disease is suddenness, most often it occurs at night. There is pain in the joint, which becomes intense over time. As the pain syndrome increases, chills, tremors appear, and the temperature may rise. Most often, gout affects the joints of the big toes. Further, the pathology can spread to larger ankle and knee joints. Sometimes salt deposits are recorded in the wrist, carpal joints. In the international classification system (ICD-10) of pathologies, this disease is assigned the code M10.0.

At risk for the disease are patients suffering from other metabolic problems: diabetes mellitus, obesity, deposition of stones in gallbladder and kidneys. Most often, pathology is diagnosed in men who have crossed the forty-year milestone, but it can also appear in childhood.

Etiology of gouty arthritis

Causes of gouty arthritis

What triggers the development of gouty arthritis? Scientists have not yet answered this question, but in their reports they cite the following risk factors:

genetic predisposition (presence of diseases in the next of kin);
not proper nutrition, a daily menu rich in meat products, chocolate, strong coffee;
abuse;
other metabolic problems;
the presence of diseases of the kidneys, heart;
hormonal deviations;
the use of certain drugs.

In childhood, the cause of pathology in most cases is considered to be metabolic failures, as well as a diet rich in meat products. Physical inactivity, frequent hypothermia can contribute to the development of arthritis against the background.

Signs and symptoms

Since gouty arthritis is classified as a disease of the musculoskeletal system, it is characterized by the same symptoms as other pathologies from this group:

redness of the skin;
increase in pain during physical activity;
subfebrile temperature (37-37.5 ° C);
general deterioration of the condition;
nervousness, insomnia;
lack of appetite.

Most often there is a chronic course of pathology with periodic relapses. The attack usually comes on suddenly against the background of the general normal state of health of the patient in the early morning or night hours. This condition is accompanied by acute pain and a rapid increase in other symptoms.

The course of the disease is directly related to the lifestyle that the patient leads. Without dietary restrictions, in the absence necessary treatment attacks will occur more often, which will gradually lead to irreversible changes in the joint.

In the initial stages of pathology, periods of remission can reach several years. Without following medical recommendations, the interval between attacks is reduced to several months or even days.

Pictured are the symptoms of gouty arthritis

In severe cases, when the disease progresses, and the clinical picture is blurred or disguised as other types of arthritis, a puncture of the synovial fluid is required. Confirmation of the diagnosis are the detected urate crystals during microscopic examination. At the same time, the synovial fluid is not cloudy, which corresponds to the sign of infectious arthritis. Its viscosity with gout may be slightly below normal.

It is very important to differentiate the pathology from other similar conditions provoked by infectious, rheumatoid arthritis or osteoarthritis, since the methods of therapy for these diseases differ significantly.

After the diagnosis of gouty arthritis is established, the patient will need to undergo a comprehensive course of therapy in order to put the pathology into remission and prevent its progression. joint problems of this kind include:

removal of an acute attack;
bed rest;
dieting;
folk remedies;
taking medications that reduce the production of uric acid and accelerate its excretion;
physiotherapy.

. Anti-inflammatory drugs used for gout: "", "", "". In the initial stages of an attack, drugs are prescribed in injections for a faster onset of the effect. Next, the patient is transferred to receive these funds in tablet form.
"". A specific drug used in gouty conditions. Helps to reduce pain, the effect occurs after 10-12 hours.
Ointments and gels. Means for external use based on NSAIDs. Apply with massage movements to the skin in the area of the affected joint.
. They are made on the basis of a 25% solution of dimexide or a semi-alcohol mixture.
Medicines that reduce the synthesis of urates: "Urikozim", "Allopurinol", "Probenecid". They do not relieve pain, promote the removal of uric acid from the blood.

During the period of treatment and after it, the patient needs. From the daily home diet, it is necessary to exclude foods that contain a large amount of purine compounds:

fatty meats, fish;
coffee;
strong tea;
chocolate;
alcoholic drinks, including beer;
meat broths;
beans;
canned and smoked products;
sorrel.

These products must be abandoned even during remission. Small deviations from the diet can lead to a relapse.

In the photo, the prognosis for gouty arthritis

Forecast

The progress of the disease can be stopped and the number of relapses reduced. Sometimes there is a loss of joint mobility, but this occurs only if the treatment conditions are not observed.

What is gouty arthritis and how to treat it, see our video:

If necessary, identify the cause of impaired renal function, use an additional code (N17-N19)

In Russia, the International Classification of Diseases of the 10th revision (ICD-10) is adopted as a single regulatory document for accounting for morbidity, reasons for the population to contact medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. №170

The publication of a new revision (ICD-11) is planned by WHO in 2017 2018.

With amendments and additions by WHO.

Processing and translation of changes © mkb-10.com

Gout mcb

Short description

Gout is a disease associated with a violation of purine metabolism, characterized by an increase in the content of uric acid in the blood (hyperuricemia) and the deposition of urates in the articular and / or periarticular tissues.

Detection of hyperuricemia is not enough to establish a diagnosis, tk. only 10% of persons with hyperuricemia suffer from gout. The most common causes are decreased excretion or increased production of uric acid.

Chronic gout is characterized by the formation of tophi.

Code according to the international classification of diseases ICD-10:

Statistical data. Hyperuricemia is found in 4-12% of the population, gout affects 0.1% of the population. The majority of patients (80-90%) are middle-aged or older with a previous 20-30 years of asymptomatic hyperuricemia. Men are more commonly affected (20:1). Before menopause, women rarely become ill, possibly due to the effect of estrogen on uric acid excretion. Acute gout attacks are rare in adolescents and young adults and are usually mediated by a primary or secondary defect in uric acid synthesis. The predominant age is over 45 years. Etiology Hyperproduction of uric acid at a normal level of its excretion is noted in 10% of patients. Primary hyperproduction is associated with defects in the enzymatic system for the synthesis of uric acid. due to increased cell breakdown in alcoholism, myeloproliferative diseases, chronic hemolysis, psoriasis or antitumor chemotherapy, increased purine catabolism in alcoholism, tissue hypoxia, excessive physical exertion, exposure to drugs: cytostatic immunosuppressants, cyanocobalamin, fructose. Violation of the excretion of uric acid (excretion of uric acid less than 700 mg / day) is observed in 90% of patients. May be associated with diseases leading to a decrease in urate clearance: renal failure, dehydration, acidosis, hyperparathyroidism, hypothyroidism, hyperaldosteronism, eclampsia, hypoestrogenemia, the action of drugs: diuretics, alcohol, small doses of acetylsalicylic acid, caffeine, diazepam, diphenhydramine, ascorbic acid, lead .

Genetic aspects. The activity of phosphoribosyl pyrophosphate synthetase 1 (311850, PRPS1 gene, Xq22 q24) is controlled by the X chromosome, so only males get sick.

The pathogenesis of a gouty attack. As a result of prolonged hyperuricemia, microtophi (accumulations of crystals) form in the synovial membrane and cartilage.

Due to trauma, fever in the joint, or changes in the concentration of uric acid in the blood or synovial fluid, the microtophi are destroyed, and the crystals enter the joint cavity.

Synovial cells produce IL - 1, IL - 6, IL - 8, which act as chemoattractants for neutrophils. Immunoglobulins and complement components opsonize (envelop) urates, stimulating the phagocytic activity of neutrophils.

The phagosomes of neutrophils that have absorbed the crystals fuse with lysosomes, and lysosomal enzymes destroy the protein shell of the crystals. Crystals damage neutrophils, and lysosomal enzymes released into the synovial cavity trigger inflammation.

M10 Gout

A form of arthritis in which crystals of uric acid (a breakdown product of cells and proteins) are deposited in the joint cavity, more often at the base of the big toe, but any other joint can be affected. This is due to excess formation of uric acid in the blood and / or its incomplete excretion from the body. Sometimes excess uric acid causes not only gout, but also the appearance of kidney stones. Repeated attacks can seriously damage the joint.

The disease can start for no apparent reason, or it can develop as a result of surgery, obesity, alcohol abuse, the use of diuretics, or increased cell destruction during chemotherapy. Gout is most common in people between the ages of 30 and 50. Seizures are very painful and disrupt a person's normal life, but they can become milder and less frequent with age. Men get sick 20 times more often; in women, the disease rarely occurs before menopause. Often the predisposition is inherited.

redness, soreness, swelling and increased temperature of the tissues around the affected joint;
joint pain, sometimes very severe;
mild fever.

In chronic gout, uric acid crystals can also be deposited in the earlobes and soft tissues of the hands, forming gouty nodules.

If gout is suspected, a blood test should be done to determine the level of uric acid. To confirm the diagnosis, joint fluid is aspirated - a sample of synovial fluid is taken and examined under a microscope.

Non-steroidal anti-inflammatory drugs, colchicine, or corticosteroids can help relieve severe pain and inflammation. If the attack persists, the doctor may inject corticosteroids directly into the joint. For recurrent gout, the patient will need lifelong treatment with prophylactic medications such as allopurinol to reduce uric acid, or medications to help eliminate uric acid from the body.

Complete medical reference book / Per. from English. E. Makhiyanova and I. Dreval.- M.: AST, Astrel, 2006.p.

Gout microbial 10: what is it?

The International Classification of Diseases of the tenth revision of the ICD-10 is a single catalog of diseases. It was established in 1990. In this classification, gout belongs to the class of connective tissue pathologies and the group of inflammatory polyarthritis.

When asked what it is, the answer will be this - it is a multiple inflammatory lesion of the joints, in which the crystalline form of uric acid accumulates. Most often, the areas of the hands and feet are affected. But localization is also possible in other areas, such a picture is typical for idiopathic forms of the disease.

It has been proven that a number of factors increase the risk of this disease, among them:

excessive consumption of alcohol and certain foods, especially meat, fish, chocolate, coffee, tea, peas, mushrooms.
impaired renal function;
allergy;
hereditary predisposition.

How pathology develops

The main cause of a disease such as gout is an increase in the level of uric acid metabolites, which are formed after cell destruction and protein breakdown, or a violation of their excretion from the blood. In this case, its deposition occurs in tissues, organs and articular cavities, and an inflammatory process begins in them.

Despite the fact that the disease is common, the causes of the pathology called gout have not yet been fully studied, the classification of microbial 10 distinguishes both a secondary form that develops with a metabolic disorder and an idiopathic one.

Gout classification mcb 10:

M10.0 Idiopathic form (gouty bursitis, primary form, tophi in the heart);
M10.1 Lead form;
M10.2 Occurs in drug allergy;
M10.3 Occurs with decreased renal function;
M10.4 Other secondary forms.

Clinical picture

In the first period, there are no symptoms, in the blood test an increased amount of uric acids, purines, creatinine and urea.

Most often, the process is asymmetric, which makes it possible to differentiate with rheumatoid arthritis, which is characterized by a symmetrical lesion. The attack usually begins with the feet, the joints of the thumb are more often affected, and forms with polyarthropathy are also known.

Exacerbation may be accompanied by fever, general malaise. On the skin, earlobes and soft tissues, specific nodes, “tophi”, are visible.

Diagnostic criteria

The diagnosis of gout code for microbial 10 M10 is used when the following symptoms are detected:

Detection of crystalline formations of uric acid in the joint fluid, or urates in the tissues.
A characteristic history of two or more episodes of pain and swelling. If the joint of the big toe is affected, one attack is enough;
Identification of tophi. With the introduction of colchicine, the pain stops.

In the course of the research, it is necessary to differential diagnosis KSD with other arthritis associated with crystal deposition, such as chondrocalcinosis, rheumatoid and psoriatic arthritis.

To do this, laboratory studies are carried out - general analysis blood, urinalysis, which reveal a high level of urates. My patients use a proven remedy, thanks to which you can get rid of pain in 2 weeks without much effort.

The patient is shown a diet without purines and alcohol, especially beer, often long-term use of drugs, such as allopurinol, is required.

Gout and gouty arthritis: ICD-10 code, causes, symptoms, treatment

Gout according to ICD-10 (International Qualification of Diseases) is classified under section M10. This is a disease in which there is a deposition of uric acid salts in the joints.

Most often, it affects the male half of humanity, who has reached the age of 40; in women, the disease occurs after the onset of menopause.

Signs of gout

A serious and significant complication is gouty arthritis. Urolithiasis may also form. The symptoms of gout include the formation of growths - tophi. They are deposited in all parts of the body. These deposits in some cases can linger in the tissues near the joints or in them themselves, then the body perceives them as a foreign body. Subsequently, the accumulation of leukocytes begins, which leads to severe inflammation - gouty arthritis.

If the deposits crack, then whitish uric acid crystals are visible. At the same time, in such places one feels very strong pain. A person cannot lead a full life. With gout, kidney stones can form, and this is the determining cause of kidney failure.

A symptom of gout is an attack of gouty arthritis - inflammation of any of the joints:

The attack mainly happens at night or early in the morning, it manifests itself as follows:

the occurrence of sudden intense pain;
tumor formation;
redness and luster of the skin.

An increase in temperature may be observed. During the daytime, the pain mostly subsides, but its attacks do not end there. Their duration can stretch from 2 to 7 days, or even longer. A repeated attack can involve other joints in a painful state, which, in turn, leads to their gradual destruction.

Causes of pathology

The underlying cause of gouty arthritis is unknown, but the disease often has a genetic basis.

Gouty arthritis can cover the joints of the fingers, both toes and hands. The cause of this disease lies in the constantly increased level of uric acid in the blood. During the course of this disease in the body in all its systems, sodium urate is deposited in the form of crystals. It is a derivative of uric acid. It is deposited in the joints in small particles. As a result, the joint is partially or completely destroyed.

Nowadays, more and more people suffer from gouty arthritis. The reason for this lies in the following:

eating foods high in calories;
alcohol abuse;
excessive consumption of products containing vegetable protein.

Repeated attacks can provoke, in addition to malnutrition, such factors:

overheating or excessive cooling of the joints;
physical activity and stress;
the use of drugs such as aspirin, diuretics, cytostatics, etc.;
infectious and chronic diseases of internal organs.

Often there is the development of gout on the background of:

diseases of the kidneys, liver and thyroid gland;
chronic renal failure;
deviations in the cardiovascular system;
overweight.

The main directions of treatment

Gout treatment consists of two stages:

elimination of an acute attack of gouty arthritis;
carrying out between periods of exacerbation of the main therapy.

During an acute attack of this disease, it is necessary that the joint is at rest. It is necessary to drink an alkaline liquid in the amount of 2.5 liters, follow a certain diet.

The doctor, in order to eliminate pain and signs of inflammation, may prescribe the following drugs:

anti-inflammatory non-steroidal;
colchicine;
hormonal glucocorticoids.

Their independent use is prohibited. Also prescribed treatment:

The main therapy aimed at eliminating relapses consists of taking drugs that prevent the formation of uric acid, promote its excretion by the kidneys, dissolve stones and prevent their occurrence.

In no case should you use drugs containing salicylic acid, because the treatment of gout is aimed at lowering the number of uric acid formations in the human body.

It will help to achieve this by following a certain diet. Products that are high in purine are excluded, and these are:

fatty fish and meat;
smoked meats and canned food;
offal;
meat of young animals.

A person suffering from gout is contraindicated in fish and meat broths, because when they are cooked, 50% of purine is transferred to them.

fresh - beans, beans, lentils;
coffee, cocoa, chocolate, tea;
cauliflower, mushrooms, spinach.

Be sure to include in your diet the following foods:

various cereals;
eggs;
milk and its products, including fermented milk;
potatoes and bread.

With gout (ICD-10 code - M10), it is necessary to significantly limit the use of table salt - 6-7 g is allowed per day. The diet should not contain mutton and pork fats, which inhibit the excretion of uric acid by the kidneys.

2. Journal "Consilium Medicum" - http://con-med.ru/;

3. Journal "Attending Doctor" - http://www.lvrach.ru/;

4. Journal of Neurology and Psychiatry. S. S. Korsakov;

5. Journal "Scientific and Practical Rheumatology";

6. Electronic journal "Angiology" - http://www.angiologia.ru/;

7. JOURNAL "ANGIOLOGY AND VASCULAR SURGERY";

Gouty arthritis ICD code

When a person notices certain symptoms in himself, he almost immediately runs to the clinic. After passing the diagnostics and passing tests, the doctor makes a diagnosis - rheumatoid arthritis.

But rheumatoid arthritis is a disease that has many subtypes.

Classification according to ICD-10

Seronegative RA, ICD-10 code - M-06.0:

Still's disease in adults - M-06.1;
bursitis - M-06.2;
rheumatoid nodule - M-06.3;
inflammatory polyarthropathy - M-06.4;
other specified RA - M-06.8;
seronegative RA, unspecified - M-06.9.

Seropositive RA, ICD-10 code - M-05:

Felty's syndrome - M-05.0;
rheumatoid lung disease - M-05.1;
vasculitis - M-05.2;
rheumatoid arthritis involving other organs and systems - M-05.3;
other seropositive RA - M-05.8;
unspecified RA - M-05.9.