A 62-year-old man with chronic kidney disease and hypertension presents with an acutely painful, swollen first metatarsophalangeal joint. He has taken...

Question

A 62-year-old man with chronic kidney disease and hypertension presents with an acutely painful, swollen first metatarsophalangeal joint. He has taken Thiazide diuretics for years. Joint aspiration confirms monosodium urate crystals. What is the most appropriate acute treatment?

Accepted Answer

Give an NSAID such as Ibuprofen if no contraindication

Answer

Start Allopurinol immediately at high dose

Answer

Give long-term Colchicine only

Answer

Start long-term Prednisolone

Answer

No treatment is required as this will self-resolve

uk-plab-1 MCQ (SBA): Acute gout

A 62-year-old man with chronic kidney disease and hypertension presents with an acutely painful, swollen first metatarsophalangeal joint. He has taken Thiazide diuretics for years. Joint aspiration confirms monosodium urate crystals. What is the most appropriate acute treatment?