Question

A 33-year-old woman presents with acute onset of hot, swollen, exquisitely tender first metatarsophalangeal (MTP) joint. She has a history of similar attacks. Serum urate is elevated. She has normal renal function. Which is the most appropriate initial management of this acute attack?

Accepted Answer

Non-steroidal anti-inflammatory drug (NSAID) such as indomethacin, unless contraindicated

Answer

Start allopurinol immediately and no other treatment

Answer

Long-term colchicine prophylaxis only

Answer

Oral prednisolone 1 mg/kg for 4 weeks

Answer

Immediate joint replacement surgery

Practice question

A 33-year-old woman presents with acute onset of hot, swollen, exquisitely tender first metatarsophalangeal (MTP) joint. She has a history of similar attacks. Serum urate is elevated. She has normal renal function. Which is the most appropriate initial management of this acute attack?