A 62-year-old woman with a history of rheumatoid arthritis presents with sudden onset, severe pain and swelling in her left great toe. She denies recent trauma. Physical exam reveals an erythematous, exquisitely tender, swollen metatarsophalangeal joint. Arthrocentesis of the joint shows negatively birefringent, needle-shaped crystals. What is the most appropriate acute treatment?

✓ Correct Answer: Option B

The patient presents with an acute gout flare, confirmed by negatively birefringent crystals. While NSAIDs and colchicine are first-line, an intra-articular glucocorticoid injection is highly effective for an acute monoarticular flare, especially if systemic options are contraindicated or insufficient. Allopurinol and febuxostat are for chronic urate lowering, not acute flares.