A Man with Fever and Joint Pain

A 64-year-old man with a history of chronic kidney disease, diabetes, and gout presented with fever, left shoulder pain, and right elbow pain. He had been seen at an urgent care twice in the past week for similar symptoms. At the urgent care, a nasal swab was positive for metapneumovirus infection, and his symptoms were attributed to a viral syndrome. He was started on a 6-day taper of methylprednisolone. The patient presented to the emergency department with worsening joint pain and continued fevers.