Date amended:
External
Statements of Principles
Current RMA Instruments
Reasonable H​ypothesis SOP59 of 2019
Balance of Probabilities SOP 60 of 2019
Changes from previous Instruments

ICD Coding
  • ICD-9-CM Codes: 274.0,274.10,274.19,274.8,274.9
  • ICD-10-AM Code: M10
Brief description

Gout is a urate crystal deposition disease that can manifest as a recurrent acute arthritis, usually involving a single joint, with asymptomatic periods between attacks.  It may also manifest as chronic tophaceous gout, with arthropathy and deposition of solid urate in connective tissues, and associated inflammation and tissue destruction.

Confirming the diagnosis

Diagnosis is based on a combination of clinical, laboratory and imaging findings.  In the case of acute gout this should include analysis of joint fluid for the presence of urate crystals.  The diagnosis can be made by a general practitioner.

The relevant medical specialist is a rheumatologist.

Additional diagnoses covered by SOP
  • Nil
Conditions excluded from SOP
  • Hyperuricaemia without clinical manifestations (N.I.F.)
  • Pseudogout#

Non-SOP condition

Clinical onset

Clinical onset will generally correspond with a first acute arthritis episode, subsequently confirmed to be due to gout.

Clinical worsening

Gout can be successfully managed with medications and lifestyle changes directed at lowering urate levels. Treament can significantly reduce the development of chronic gouty arthritis and tophaceous gout. Progression of disease may indicate non-compliance with treatment.