As if getting shot in the kneecap didn’t suck enough, this man's gunshot injury silently lurked within him for over a decade, before re-emerging and causing some cringe-inducing complications.

The unusual saga came to light when a 46-year-old man was brought to the emergency room at John H Stroger Hospital of Cook County in Chicago with complaints of pain in his left knee, according to a medical case study in the New England Journal Medicine last month. A brief glance into his medical history brought up X-rays that revealed he had sustained a gunshot wound to the left knee some 14 years previous. For reasons that remain unclear, the bullet was never removed.

A physical examination by doctors on the case noted that his knee still appeared to hold a lot of excess fluid. However, further radiograph X-rays revealed the true nature of the problem. Along with the joint showing clear signs of arthritis, the bullet appeared to have become fragmented into metallic shards and spread throughout the knee.

Lab tests also showed his blood contained elevated lead levels. Nevertheless, the man was fairly fortunate as he did not experience any of the usual hallmarks of chronic lead poisoning: organ failure and severe problems with the central nervous system and brain function.

Contact with bullets is a relatively common cause of lead poisoning. However, exposure to lead is thought to be on the decrease due to increased awareness of its perils. In days gone by, one of the leading causes of lead exposure was paint. It’s even suggested that many of the world’s famously “eccentric” artists were actually suffering from the effects of lead poisoning, such as Caravaggio, Francisco Goya, Frida Kahlo, and – most famously – Vincent Van Gogh.

The man underwent chelation therapy to "suck out" the heavy metals from his body. The doctors planned to carry out surgery on his knee, however he left the ward unannounced before the operation and staff were unable to track him down.

Every medical case study appears to have an important message, and this one is no different: If you get shot in a joint, doctors should strongly think about getting it out of there ASAP. Failing that, don't just run away from hospital appointments.