Incidence, symptomatology, diagnosis, prognosis and treatment of gonococcal arthritis

Abstract

(1). Out of 4000 cases of gonorrhoea that have "beenreviewed, arthritis was a complication in119. It was more common in men than inwomen (4:1); and it was more often poly­articular than monarticular. (5:1)(2). The common sites of infection were the pros­tate and the seminal vesicles in men; inwomen they were the cervix uteri, theurethra, the Barth©linian glands, and theuterine tubes.(3). The joint most frequently involved was the knee(64fo); the others are named in their or­der of frequency - ankle, metatarso -phalangeal, shoulder, wrist, metacarpo -phalangeal, elbow, hip, inter-vertebraland mandibular.(4). The signs and symptons of gonococcal arthritis are analysed.(5). It is shown that: a) In diagnostio procedure thorough exami­nation of the lower genito-urinary tract is essential; b) the complement-fixation test, when posi­tive, is diagnostic of gonorrhoea, and is of special value in those oases in which bacteriological evidence is lacking; c) radiograms of the affected joints are of no positive diagnostic aid, hut their negative evidence is sometimes of value.(6). A critical review of the various methods of treatment is attempted, and the impor­tance of treating the primary infectionis emphasised.(7). In acute and subacute cases, the prognosis is always good under suitable treatment -both local, focal, and general. In chronic cases the prognosis is unfavour­able, and varies directly with the degreeof involvement of the intre - and peri­articular structures.are analysed.