A 62-year-old man presents with sudden onset severe pain, redness and swelling of the first metatarsophalangeal joint. He has a history of hypertensio...

Question

A 62-year-old man presents with sudden onset severe pain, redness and swelling of the first metatarsophalangeal joint. He has a history of hypertension and chronic kidney disease stage 3b (eGFR 35 mL/min/1.73 m²). What is the most appropriate initial pharmacological treatment for this acute attack?

Accepted Answer

Oral Colchicine at reduced dose.

Answer

High-dose NSAID such as Ibuprofen 800 mg three times daily.

Answer

Immediate start of Allopurinol at high dose.

Answer

Intra-articular steroid injection only in primary care.

Answer

Long-term low-dose Aspirin.

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