Question

A 47-year-old man presents with acute onset of a hot, swollen, very tender first metatarsophalangeal joint. He is afebrile and has no systemic symptoms. This is his first episode. Which initial management is most appropriate if septic arthritis is unlikely?

Accepted Answer

Start oral NSAID such as naproxen and advise rest and ice

Answer

Start long-term allopurinol immediately

Answer

Prescribe long-term colchicine prophylaxis without acute treatment

Answer

Perform joint replacement surgery

Answer

Give intra-articular steroid without excluding infection

Practice question

A 47-year-old man presents with acute onset of a hot, swollen, very tender first metatarsophalangeal joint. He is afebrile and has no systemic symptoms. This is his first episode. Which initial management is most appropriate if septic arthritis is unlikely?