A 27-year-old man presents with acute onset monoarthritis of the first metatarsophalangeal joint, which is red, hot and exquisitely tender. He drinks ...

Question

A 27-year-old man presents with acute onset monoarthritis of the first metatarsophalangeal joint, which is red, hot and exquisitely tender. He drinks alcohol regularly and has a high BMI. Serum urate is elevated. What is the most appropriate initial management of this acute attack?

Accepted Answer

Non-steroidal anti-inflammatory drug unless contraindicated

Answer

Start Allopurinol immediately

Answer

Long-term Colchicine prophylaxis only

Answer

Immediate joint replacement surgery

Answer

Oral antibiotics for presumed septic arthritis

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

A 27-year-old man presents with acute onset monoarthritis of the first metatarsophalangeal joint, which is red, hot and exquisitely tender. He drinks alcohol regularly and has a high BMI. Serum urate is elevated. What is the most appropriate initial management of this acute attack?