A 46-year-old man has 12 hours of severe first metatarsophalangeal joint pain and swelling. He has chronic kidney disease stage 3 and peptic ulcer

Question

A 46-year-old man has 12 hours of severe first metatarsophalangeal joint pain and swelling. He has chronic kidney disease stage 3 and peptic ulcer disease. Synovial fluid shows needle-shaped negatively birefringent crystals. Which of the following is the most appropriate next step in management?

Accepted Answer

Oral colchicine at anti-inflammatory dosing

Answer

Arthroscopic lavage of the joint

Answer

High-dose ibuprofen for 2 weeks

Answer

Urate-lowering therapy as sole acute treatment

Answer

Long-term antibiotic therapy

Gout flare — USMLE Step 3 MCQ

A 46-year-old man has 12 hours of severe first metatarsophalangeal joint pain and swelling. He has chronic kidney disease stage 3 and peptic ulcer disease. Synovial fluid shows needle-shaped negatively birefringent crystals. Which of the following is the most appropriate next step in management?