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Gout Without Oral Access — SCE Rheumatology MCQ

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HardCrystal ArthropathyGout Without Oral AccessSCE Rheumatology

A hospitalised patient who is nil by mouth develops a severe gout flare. NSAIDs are contraindicated. Which non-oral treatment is appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Intramuscular, intravenous or intra-articular glucocorticoid

A parenteral or intra-articular glucocorticoid is appropriate when oral therapy is unavailable and NSAIDs cannot be used, after septic arthritis is excluded when relevant. Intravenous colchicine is not used because of severe and potentially fatal toxicity.

Reference: NICE NG219: gout — recommendations (Published June 2022): https://www.nice.org.uk/guidance/ng219/chapter/Recommendations; BNF: colchicine (Current BNF monograph, accessed 30 July 2026): https://bnf.nice.org.uk/drugs/colchicine/