A toxic exposure in a home aquarium results in sudden, excruciating pain for a 48-year-old man. A 48-year-old man with a history of diabetes is cleaning his salt-water aquarium when he feels a sudden sharp pain in his right hand. He takes an over-the-counter non-steroidal anti-inflammatory drug, which does not relieve his pain. He presents to the ED complaining of severe pain radiating from his right hand to his shoulder.