Question

A 40-year-old man presents with acute onset of a swollen, red, and very painful first metatarsophalangeal joint. He reports a history of similar attacks. Serum uric acid today is 8.5 mg/dL. Which is the most appropriate management of this acute attack?

Accepted Answer

Start colchicine or NSAIDs for acute inflammation and delay initiation of urate lowering therapy until after the flare resolves

Answer

Start allopurinol immediately and no other therapy

Answer

Start long-term probenecid during the acute flare

Answer

Use chronic low-dose prednisone alone long-term

Answer

Treat with antibiotics for presumed septic arthritis

Practice question

A 40-year-old man presents with acute onset of a swollen, red, and very painful first metatarsophalangeal joint. He reports a history of similar attacks. Serum uric acid today is 8.5 mg/dL. Which is the most appropriate management of this acute attack?