Question

A 58-year-old man presents with a hot, swollen first metatarsophalangeal joint. Joint aspiration shows needle-shaped, negatively birefringent crystals. What is the most appropriate initial pharmacologic therapy for this acute attack?

Accepted Answer

High-dose NSAID if no contraindications

Answer

Low-dose acetylsalicylic acid

Answer

Allopurinol initiation during the acute flare

Answer

Colchicine prophylaxis only

Answer

Intra-articular corticosteroid is contraindicated

Practice question

A 58-year-old man presents with a hot, swollen first metatarsophalangeal joint. Joint aspiration shows needle-shaped, negatively birefringent crystals. What is the most appropriate initial pharmacologic therapy for this acute attack?