Soru

A 74-year-old man is evaluated on postoperative day 3 following an elective open inguinal hernia repair due to new-onset right knee pain and swelling. The pain began overnight and has become so severe that he cannot bear weight on his right leg. His medical history is significant for hypertension, chronic kidney disease stage 3b (baseline creatinine $2.1$ mg/dL), and a history of a bleeding gastric ulcer $2$ years ago. His temperature is $38.1$°C ($100.6$°F), blood pressure is $142/86$ mm Hg, and pulse is $98$/min. Physical examination of the right knee reveals marked effusion, erythema, and warmth. The joint is exquisitely tender to palpation, and range of motion is severely limited by pain. Arthrocentesis is performed, yielding $15$ mL of cloudy yellow fluid. Synovial fluid analysis shows a leukocyte count of $32,000/\mu L$ with $85\%$ neutrophils. Polarized light microscopy reveals numerous rhomboid-shaped crystals that exhibit weak positive birefringence. Gram stain shows no organisms. Which of the following is the most appropriate next step in management?