Question

A 62-year-old man presents with a hot, swollen, exquisitely tender first metatarsophalangeal joint. He has known gout and drank heavily over the weekend. What is the most appropriate pharmacological management of this acute attack, assuming no contraindications?

Accepted Answer

Use an NSAID such as naproxen at an appropriate dose until the attack settles

Answer

Start allopurinol immediately at a high dose

Answer

Start long-term colchicine prophylaxis only

Answer

Give intra-articular corticosteroid alone without systemic treatment

Answer

Use opioids only for pain relief

Practice question

A 62-year-old man presents with a hot, swollen, exquisitely tender first metatarsophalangeal joint. He has known gout and drank heavily over the weekend. What is the most appropriate pharmacological management of this acute attack, assuming no contraindications?