Soru

A 68-year-old man is evaluated on the medical ward for severe right knee pain and swelling that began abruptly overnight. He was admitted $3$ days ago for community-acquired pneumonia, which has been improving on empiric intravenous ceftriaxone and oral clarithromycin. His medical history is significant for ischemic cardiomyopathy with a left ventricular ejection fraction of $25\%$, chronic kidney disease stage 4 (baseline serum creatinine $2.7 \text{ mg/dL}$), and poorly controlled type 2 diabetes mellitus.

Current medications include lisinopril, carvedilol, furosemide, dapagliflozin, and insulin glargine.

Vital signs are temperature $37.2^\circ\text{C}$ ($99.0^\circ\text{F}$), blood pressure $112/68 \text{ mmHg}$, pulse $88/\text{min}$, and respirations $16/\text{min}$.
Physical examination reveals a warm, erythematous, swollen, and exquisitely tender right knee. Range of motion is severely limited by pain. The remainder of the examination is notable for trace bilateral pitting lower extremity edema.

Laboratory studies obtained this morning show:
Blood urea nitrogen: $48 \text{ mg/dL}$
Creatinine: $2.9 \text{ mg/dL}$
Glucose, fasting: $285 \text{ mg/dL}$

Right knee arthrocentesis yields $15 \text{ mL}$ of cloudy yellow fluid. Synovial fluid analysis shows a leukocyte count of $45,000/\mu\text{L}$ ($85\%$ neutrophils). Polarized light microscopy reveals negatively birefringent, needle-shaped crystals. Gram stain is negative for organisms.

Which of the following is the most appropriate next step in the pharmacologic management of this patient's acute joint condition?