ABSTRACT
Consider this case: A 37-year-old male bartender had been well until he developed increasing pain in his left knee, which became hot and swollen. A few days later, pain, swelling, and heat developed in his left wrist and right knee. Examination revealed swelling, heat, and effusion in both knees and left wrist. There were no deformities. His liver was enlarged 2 cm below the costal margin. The complete blood count was normal. There were excess pus cells in his urine. His fever was 100°F. (Adapted from Arkes, Saville, Wortmann, & Harkness, 1981).
