M10.35

Clinical Causes: Chronic kidney disease or renal impairment reduces the kidney’s capacity to excrete uric acid effectively. High intake of purine-rich foods such as red meats, shellfish, and alcohol increases uric acid production. Certain medications, like diuretics, can contribute to elevated uric acid levels. Genetic predisposition affecting uric acid metabolism may play a role. Obesity, which can be linked to increased production and decreased elimination of uric acid. Dehydration, leading to concentrated uric acid levels in the blood.

Key Symptoms: Sudden and intense pain in the hip joint, which may worsen over a few hours. Swelling and warmth around the affected hip. Redness and tenderness of the skin over the joint. Limited range of motion due to pain and swelling. Episodes often occur suddenly, frequently at night. Possible fever if the gout attack is severe or infected.

Diagnosis Path: Joint fluid analysis to identify uric acid crystals. Blood tests measuring serum uric acid levels. Imaging studies like X-rays, ultrasound, or dual-energy CT scans to detect joint damage or crystal deposits. Assessment of kidney function to evaluate the extent of renal impairment.

Treatment Protocols: Medications like nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief during acute attacks. Colchicine, which helps reduce inflammation if administered early during a flare. Corticosteroids, either oral or injectable, for severe cases or when NSAIDs are contraindicated. Urate-lowering therapies such as allopurinol or febuxostat to prevent future attacks by decreasing uric acid production. Lifestyle modifications including dietary changes to limit purine intake, maintain hydration, and manage weight. Addressing the underlying renal impairment through medical management and lifestyle adjustments to improve kidney health.