True statements regarding acute attack of gouty ahritis is all EXCEPT:
Allopurinol should be staed immediately REF: Goodman Gillman manual of pharmacology and therapeutics 2008 edition page 458, Katzung 9th edition page 599, Harrison 17th ed chapter 327 "The incidence of acute attacks of gouty ahritis may increase during the early months of allopurinol therapy as a consequence of mobilization of tissue stores of uric acid. Co-administration of colchicine helps suppress such acute attacks. After reduction of excess tissue stores of uric acid, the incidence of acute attacks decreases and colchicine can be discontinued" During acute gouty attacks, strongly birefringent needle-shaped MSU crystals with negative elongation are typically seen both intracellularly and extracellularly Serum uric acid levels can be normal or low at the time of the acute attack, as inflammatory cytokines can be uricosuric and effective initiation of hypouricemic therapy can precipitate attacks. This limits the value of serum uric acid determinations for the diagnosis of gout MP mainstay of treatment during an acute attack is the administration of anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, or glucocoicoids.
Joint aspirate reveals positive birefringent crystals
Allopurinol should be staed immediately
Colchicine is known to provide relief
Serum Uric acid levels may be absolutely normal