{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:46:38Z","timestamp":1785775598590,"version":"3.56.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 49-year-old man presented with confusion, hallucinations, and seizure-like episodes. Evaluation revealed severe anemia and knee imaging showed lead synovitis from a gunshot wound received 27 years previously. Substance-related causes initially complicated the clinical picture, but further testing identified a critically elevated blood lead level. The patient was treated with chelation therapy and surgery to remove a retained bullet fragment and inflamed, metal-stained synovial tissue. After treatment, his mental status normalized and blood lead levels steadily declined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case highlights that retained intra-articular bullets can cause severe lead poisoning decades later, requiring early recognition and combined medical\/surgical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.26.00055","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:01:30Z","timestamp":1785434490000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Lead Poisoning Secondary to Retained Intra-articular Bullet"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0148-7948","authenticated-orcid":false,"given":"Damon","family":"Dunwody","sequence":"first","affiliation":[{"name":"Georgia Orthopedic Trauma Institute, Mercer University School of Medicine, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Lambert","sequence":"additional","affiliation":[{"name":"Georgia Orthopedic Trauma Institute, Mercer University School of Medicine, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Register","sequence":"additional","affiliation":[{"name":"Georgia Orthopedic Trauma Institute, Mercer University School of Medicine, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7417-2054","authenticated-orcid":false,"given":"Matthew","family":"Martell","sequence":"additional","affiliation":[{"name":"Georgia Orthopedic Trauma Institute, Atrium Health Navicent Medical Center, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0735-8182","authenticated-orcid":false,"given":"William","family":"Padget","sequence":"additional","affiliation":[{"name":"Georgia Orthopedic Trauma Institute, Atrium Health Navicent Medical Center, Macon, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"issue":"17","key":"bib2-20260803","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1056\/NEJMra2402527","article-title":"Lead poisoning","volume":"391","author":"Lanphear","year":"2024","journal-title":"New Engl J Med."},{"issue":"8","key":"bib3-20260803","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1097\/HJH.0000000000003713","article-title":"Lead-associated mortality in the US 1999-2020: a time-stratified analysis of a national 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