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Gout acute flare — USMLE Step 3 MCQ

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ModerateAmbulatory Medicine / Primary CareGout acute flareUSMLE Step 3

A 53-year-old man with hypertension has 18 hours of severe pain and swelling at the first metatarsophalangeal joint. He has had two prior similar attacks. He is afebrile, and there is no wound. Creatinine is 0.9 mg/dL. Joint aspiration shows negatively birefringent needle-shaped crystals and no organisms. Which of the following is the most appropriate next step in management?

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Correct answer: C — Treat with oral NSAID therapy

Acute gout flare is treated with an NSAID, colchicine, or glucocorticoid if appropriate; infection is excluded by aspiration.

Reference: ACR Gout Guideline