Case of a Man with Deformity in His Knees, Ankles, and Wrist Joint

History A 47-year-old man presented with a deformity in his knees, ankles, wrist joint, and right thumb for two weeks (Figure 1 and Figure 2) . The patient was previously treated conservatively for alcohol-related acute pancreatitis . Computed tomography analysis of the abdomen at that time showed an enlarged pancreas for which the patient underwent surgery for pancreatic pseudocyst five years back . Physical examination Joints were swollen, erythematous, and tender . The patient was initially treated for septic arthritis.

Initial treatment Thick pus was aspirated from the knee joints. The patient was administered with broad-spectrum intravenous antibiotics (meropenem and vancomycin). Arthrotomy and lavage of the knees for septic arthritis were performed. Radiological examination CT of the abdomen revealed a pancreatic pseudocyst. (Figure 3) Serum amylase was reported to be elevated…