A 50-year-old male presents with acute onset severe pain, swelling, and erythema of his right great toe, which started suddenly last night. He denies trauma. He has a history of hypertension. Arthrocentesis shows negatively birefringent needle-shaped crystals. What is the most appropriate initial treatment?

✓ Correct Answer: Option D

The patient presents with an acute gout flare, confirmed by arthrocentesis. Nonsteroidal anti-inflammatory drugs (NSAIDs) like indomethacin are considered first-line therapy for rapid symptom relief unless contraindicated. Allopurinol and probenecid are for long-term prophylaxis and should not be initiated during an acute flare.