Answer 3 Intra-articular corticosteroids. Intra-articular corticosteroids would the most appropriate treatment given the patient’s history of diabetes and renal insufficiency. While indomethacin is the traditional first-line agent, the patient’s age, renal insufficiency, and hypertension would make it a less desirable choice. Colchicine is also a traditional choice, but patient’s renal insufficiency, complicated administration schedule, and risk of side effects would not make it a first option. Allopurinol does not treat an acute attack of gout and, in fact, may worsen it. Click here to return to the questions

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