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November 22, 1976

Gonococcal Osteomyelitis: An Unusual Complication of Gonococcal Arthritis

Author Affiliations

From the departments of medicine (Drs Gantz and Cohen), and radiology (Dr Shauffer), Thorndike Memorial Laboratory, Boston City Hospital and Boston University School of Medicine; and the Channing Laboratory, departments of medicine and medical microbiology, Boston City Hospital, Harvard Medical School (Drs McCormack and Laughlin), Boston.

JAMA. 1976;236(21):2431-2432. doi:10.1001/jama.1976.03270220051040

GONOCOCCAL arthritis, which usually responds readily to appropriate antimicrobial therapy, is a potentially destructive process. Before the introduction of antimicrobial agents, 23% to 85% of patients who recovered from gonococcal arthritis had residual joint damage.1 Although osteomyelitis has been described as a complication of infective arthritis caused by bacteria other than the gonococcus, it has been infrequently associated with gonococcal arthritis. We report the case of a young woman who had gonococcal arthritis with contiguous osteomyelitis.

Report of a Case  A 31-year-old woman was admitted to Boston City Hospital with pain and swelling of the second right metacarpophalangeal joint. She was well until six weeks prior to admission, when she noted pain in the left hand and shoulder and in both wrists. Four weeks prior to admission, she came to the emergency room because of pain and swelling of the second, third, and fourth left metacarpophalangeal and proximal interphalangeal joints.