A 59-year-old man presents with an acutely painful, swollen first metatarsophalangeal joint. The pain started overnight and he cannot bear weight. He ...

Question

A 59-year-old man presents with an acutely painful, swollen first metatarsophalangeal joint. The pain started overnight and he cannot bear weight. He has a history of hyperuricaemia and drinks alcohol regularly. What is the most appropriate initial pharmacological treatment?

Accepted Answer

Oral NSAID such as Ibuprofen, if no contraindications

Answer

Start Allopurinol immediately at high dose

Answer

Oral Colchicine should be avoided in acute attacks

Answer

Oral Prednisolone must always be first-line

Answer

Topical analgesic gel alone

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

A 59-year-old man presents with an acutely painful, swollen first metatarsophalangeal joint. The pain started overnight and he cannot bear weight. He has a history of hyperuricaemia and drinks alcohol regularly. What is the most appropriate initial pharmacological treatment?