Practice question

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A 52-year-old man presents with a painful, swollen, red big toe on his right foot, which started acutely overnight. He has never had this before. He drinks 2-3 pints of beer most evenings. Examination confirms swelling, erythema, warmth, and extreme tenderness of the first metatarsophalangeal joint. What is the most appropriate initial management for the acute attack?

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