Acute venereal arthritis. Comparative study of acute Reiter syndrome and acute gonococcal arthritis.
Acute venereal arthritis, a syndrome of fever and inflammatory arthritis following recent sexual intercourse, is a frequently misdiagnosed arthritic presentation. Nearly half of 39 patients admitted with a diagnosis of acute gonococcal arthritis were subsequently recognized as having acute Reiter syndrome. A retrospective study of both diseases revealed differentiating features that, when prospectively applied to 21 consecutive patients, permitted a correct and prompt bedside diagnosis. Acute Reiter syndrome could be differentiated by characteristic mucucutaneous lesions, arthritis/tenosynovitis confined to lower extremities, massive recurrent knee effusions, low back pain, conjunctivitis, and genitourinary inflammation. Gonococcal arthritis could be differentiated by migratory arthralgias, high fevers, arthritis/tenosynovitis initially confined to upper extremities, typical cutaneous lesions, and dramatic defervescence to penicillin therapy. Laboratory data provided support for each diagnosis.
D000293:Adolescent; D000328:Adult; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D016918:Arthritis, Reactive / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005533:Foot Dermatoses / Q000473:pathology; D006069:Gonorrhea / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D006680:HLA Antigens; D006650:Histocompatibility Testing; D006801:Humans; D007642:Keratosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D012189:Retrospective Studies
D006680:HLA Antigens