skip to main content

Acute gout in chronic kidney disease — ABIM Board MCQ

Instant feedback + full explanation. One question, done properly.

HardRheumatology/Allergy/ImmunologyAcute gout in chronic kidney diseaseABIM Board

A 58-year-old with CKD stage 4 and apixaban treatment has acute monoarticular gout confirmed by crystals; aspiration has excluded infection. Which flare treatment is safest?

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

Reveal the answer and explanation

Correct answer: C — Use intra-articular or brief systemic glucocorticoid treatment

Glucocorticoids avoid the renal and bleeding hazards of NSAIDs and the toxicity risk of high-dose colchicine in advanced CKD. Probenecid is not acute analgesia and is ineffective with marked renal impairment; stopping anticoagulation to permit aspirin is unsafe and unhelpful.

Reference: American College of Rheumatology, 2020 Gout Guideline: https://pubmed.ncbi.nlm.nih.gov/32390306/