A 62-year-old man with chronic gout and CKD stage 3 presents with an acute monoarthritis of the first metatarsophalangeal joint, red and very tender. ...

Question

A 62-year-old man with chronic gout and CKD stage 3 presents with an acute monoarthritis of the first metatarsophalangeal joint, red and very tender. He is on low-dose allopurinol. What is the most appropriate treatment for this acute attack?

Accepted Answer

Intra-articular steroid injection or short oral steroid course if infection excluded

Answer

High-dose NSAIDs without dose adjustment

Answer

Colchicine at reduced dose appropriate for renal function

Answer

Increase allopurinol dose immediately

Answer

Combination of colchicine and NSAIDs at full doses regardless of renal function

au-racp MCQ (SBA): Acute gout in CKD

A 62-year-old man with chronic gout and CKD stage 3 presents with an acute monoarthritis of the first metatarsophalangeal joint, red and very tender. He is on low-dose allopurinol. What is the most appropriate treatment for this acute attack?