Incidence, symptomatology, diagnosis, prognosis and treatment of gonococcal arthritis
Basset, John Mories
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(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.