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November 18, 1983

Gonococcal Osteomyelitis Complicating Septic Arthritis

Author Affiliations

From the Department of Rheumatology, Providence Medical Center, Portland, Ore (Dr Tindall); and the Department of Medicine, Dartmouth-Hitchcock Medical Center, Hanover, NH (Dr Regan-Smith).

JAMA. 1983;250(19):2671-2673. doi:10.1001/jama.1983.03340190073037

GONOCOCCAL arthritis is common and well described.1 It is easily treated with antibiotics and usually has no serious sequelae. While nongonococcal septic arthritis frequently is associated with osteomyelitis, gonococcal osteomyelitis is rare.

We report a case of gonococcal osteomyelitis in a young man that resulted in permanent disability.

Report of a Case  A 29-year-old man had a sudden onset of right shoulder pain associated with a temperature of 39 °C and malaise. On day 8 of his illness, his joint findings were reported to be normal. His sedimentation rate was 52 mm/hr (Westergren). Despite therapy with phenylbutazone (Butazolidin), migratory arthralgias developed, involving his wrists, ankles, hips, and shoulder, with red, tender swelling of his left wrist and right ankle.The patient was hospitalized on day 10 with persistent joint complaints. Physical examination disclosed limited abduction of his right shoulder, tender ankles and left wrist, and pain on motion of