Question

A 62-year-old man presents with an acutely swollen, red, very tender right first metatarsophalangeal joint. He has a history of similar attacks. He has CKD stage 3 and hypertension. What is the most appropriate initial treatment of this acute attack?

Accepted Answer

Colchicine 1 mg stat then 0.5 mg 1 hour later, with dose adjustment for renal impairment

Answer

Start allopurinol immediately and titrate to urate target

Answer

High-dose indomethacin 50 mg three times daily for 5 days

Answer

Long-term low-dose prednisone 5 mg daily

Answer

Intra-articular corticosteroid injection is contraindicated

Practice question

A 62-year-old man presents with an acutely swollen, red, very tender right first metatarsophalangeal joint. He has a history of similar attacks. He has CKD stage 3 and hypertension. What is the most appropriate initial treatment of this acute attack?