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Acute gout — ABFM Board MCQ

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ModerateMusculoskeletal/Sports medicineAcute goutABFM Board

A 52-year-old man has sudden severe pain in the first metatarsophalangeal joint. The joint is red, swollen, and tender. He has chronic kidney disease stage 3 and takes hydrochlorothiazide. Which of the following is the most appropriate initial treatment?

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Correct answer: A — Oral prednisone or intra-articular corticosteroid

Acute gout can be treated with NSAIDs, colchicine, or corticosteroids. In chronic kidney disease, corticosteroids are often safer than NSAIDs or higher-dose colchicine. Urate-lowering therapy is not sole acute treatment.

Reference: ACR Gout Guideline