Intra-articular steroid + lido w/o (I like triamcinolone the best) 20 mg for small joints is perfect.
For the oral steroid, I like Prednisone 40 mg every morning for seven days.
Prescription will read prednisone 20 mg, two tabs PO Qa.m.
If prescribing oral steroids, I put patients on famotidine 40 mg one tablet by mouth twice a day for 14 days Do not prescribe allopurinol for acute gout flair.
Wait until they are six weeks resolved to initiate that, otherwise you can cause an acute flare/worsening of the gout.