M10.03

Clinical Causes: Elevated uric acid levels in the blood (hyperuricemia) Diet high in purine-rich foods such as red meats, shellfish, and alcoholic beverages Obesity or overweight status Certain medications like diuretics or immunosuppressants Genetic factors that affect uric acid metabolism Kidney dysfunction impairing uric acid excretion Dehydration or rapid weight loss Medical conditions such as hypertension or metabolic syndrome

Key Symptoms: Sudden and intense wrist pain, often waking the person from sleep Swelling and redness around the wrist joint Warmth and tenderness upon touching the affected area Limited movement in the wrist during flare-ups Possible formation of tophi (firm lumps of uric acid crystals under the skin, though less common in initial episodes) Fever may be present in severe cases

Diagnosis Path: Order blood tests to measure serum uric acid levels; however, elevated levels are not definitive alone Perform joint aspiration to extract synovial fluid from the wrist and examine it under a microscope for uric acid crystals Use imaging studies like X-rays or ultrasound to detect joint damage or tophi Assess for other conditions that may mimic gout, such as infection or other types of arthritis

Treatment Protocols: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to reduce pain and inflammation Colchicine to decrease crystal formation and prevent attacks Corticosteroids, administered orally or via injection into the joint, to control inflammation Uric acid-lowering medications like allopurinol or febuxostat to manage hyperuricemia Lifestyle changes including reducing intake of purine-rich foods, limiting alcohol, maintaining healthy weight, and staying well-hydrated Warm or cold compresses to alleviate pain and swelling In some cases, joint aspiration or surgery may be considered if there are persistent tophi or joint damage