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Condition/Disorder Synonyms

  • Hyperuricemia

  • Tophaceous gout

  • Gouty arthritis

ICD-9-CM Codes

  • 274.9 Gout, unspecified

  • 315.4 Coordination disorder (Clumsiness, dyspraxia and/or specific motor development disorder)

  • 718.03 Articular cartilage disorder, forearm

  • 718.04 Articular cartilage disorder, hand

  • 718.07 Articular cartilage disorder, ankle and foot

  • 719.39 Palindromic rheumatism involving multiple sites

  • 719.4 Pain in joint

  • 729.1 Myalgia and myositis, unspecified

  • 736.9 Acquired deformity of limb

  • Physical Therapy Diagnoses/ Treatment Diagnoses that may be associated with Rheumatologic disorders affecting movement:

    • - 718.45 Contracture of joint; pelvic region and thigh

    • - 719.70 Difficulty Walking

    • - 728.89 Other disorders of muscle, ligament and fascia

    • - 728.2 Muscular wasting and disuse atrophy

    • - 729.9 Other disorders of soft tissue

    • - 781.2 Abnormality of gait: ataxic, paralytic, spastic, staggering

    • - 782.3 Edema

ICD-10-CM Code

  • M10.9 Gout, unspecified

Preferred Practice Patterns

Key Features


  • Gout is a form of arthritis that is caused by uric acid (sodium urate) buildup in the blood, resulting in crystal formation that can inflame the joints

  • Considered a rheumatic condition because it involves the joints

  • Joint pain; often in great toe, knee or ankle; episodic but may last for long periods of time

  • Onset sudden; may be over course of a day, and frequently with severe pain at night

  • Edema

  • Soft tissue pain surrounding affected joints

  • Kidney dysfunction

Essentials of Diagnosis

  • (Which must be made by a physician and confirmed by medical diagnostic testing)

  • Acute or chronic

  • Elevated uric acid levels (hyperuricemia) based on lab values

  • Synovial fluid samples from inflamed joints with presence of uric acid

  • Culture of joint fluid if infections suspected

  • Inflamed, painful joints with rather sudden onset

  • 4 stages (National Institutes of Health)

    • - Asymptomatic hyperuricemia

      • Elevated uric acid levels only

    • - Acute gout or acute gouty arthritis

      • Uric acid deposits in joints resulting in sudden, severe pain

      • Joints may or may not be red and or tender

      • Often occurs at night

    • - Interval or intercritical gout

      • Period between attacks - asymptomatic

    • - Chronic tophaceous gout

      • Most disabling

      • Develops over long period (~ 10 years)

      • Permanent joint damage

      • May be permanent damage to kidneys

      • Unusual with treatment/management

General Considerations

  • Differential diagnosis may take time and require intensive medical diagnostic testing as gout must be differentiated from other conditions that present similarly

  • May be misdiagnosed or confused with pseudogout which presents similarly but deposits are phosphate crystals in pseudogout

  • May result in secondary problems such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, ...

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