Question

A 58-year-old woman with long-standing gout presents with an acute monoarthritis of the first metatarsophalangeal joint. She is not on urate-lowering therapy. According to rheumatology guidelines, which management strategy during the acute flare is most appropriate?

Accepted Answer

Treat the acute flare with NSAIDs or colchicine and delay initiation of allopurinol until after the flare has settled

Answer

Start allopurinol immediately and withhold anti-inflammatory agents

Answer

Use long-term low-dose prednisone as first-line gout management

Answer

Rely solely on dietary modification without pharmacotherapy

Answer

Use allopurinol only during flares and stop between attacks

Practice question

A 58-year-old woman with long-standing gout presents with an acute monoarthritis of the first metatarsophalangeal joint. She is not on urate-lowering therapy. According to rheumatology guidelines, which management strategy during the acute flare is most appropriate?