A Pain in the...Arm

A toxic exposure injury in a metal shop results in severe extremity pain for a 55-year-old man. A 55-year-old man with an unremarkable medical history presents to the ED complaining of pain in his left forearm and hand. Patient acknowledges drinking an excessive volume of ethanol at his friend's metal shop the previous evening and, later, passing out there. He noted extremity pain immediately upon awakening and noticed that his arm was resting in a shallow puddle that had presumably leaked from a nearby container. Pain continued to increase over the next 2 hours.