A 65-year-old man presents with sudden onset pain, swelling and redness of his first metatarsophalangeal joint. He has a history of hyperuricaemia. Jo...

Question

A 65-year-old man presents with sudden onset pain, swelling and redness of his first metatarsophalangeal joint. He has a history of hyperuricaemia. Joint aspiration shows negatively birefringent needle-shaped crystals. What is the most appropriate initial treatment?

Accepted Answer

High-dose oral NSAID (e.g. Naproxen) or Colchicine

Answer

Start Allopurinol immediately

Answer

Long-term low-dose Prednisolone

Answer

Intra-articular steroid injection as first-line in all cases

Answer

Prophylactic antibiotics

uk-plab-1 MCQ (SBA): Acute gout

A 65-year-old man presents with sudden onset pain, swelling and redness of his first metatarsophalangeal joint. He has a history of hyperuricaemia. Joint aspiration shows negatively birefringent needle-shaped crystals. What is the most appropriate initial treatment?