Gonorrhoeal rheumatism and gonococcic infection / by William Murrell.

  • William Murrell
Date:
[1909?]
Catalogue details

Licence: In copyright

Credit: Gonorrhoeal rheumatism and gonococcic infection / by William Murrell. Source: Wellcome Collection.

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    hand arc frequently involved. Certain joints not usually attacked by rheumatism may be implicated, notably the temporo-maxillary, the sacro-iliac and the sterno-clavicular. Implication of these in my experience not very common, and is certainly not seen in more than 5 per cent, of the cases. The onset is usually marked by swelling and pain, the swelling being due to the effusion of serum into the joint cavity and its surrounding tissues. There is little redness or blush on the surface, and the pain, although severe, is not comparable to that of gout or acute rheumatism. Exception¬ ally, however, arthralgia is the prominent symptom, and there may be little swelling or other evidences of inflamma¬ tion. Metastasis is not common, and there is no tendency for the inflammation to shift from one joint to another, a point of diagnostic importance. Effusion into the tendon sheaths is of frequent occurrence, especially when the wrist and ankle are involved. The dome-shaped swelling of the dorsum of the hands is common, but is also met with in gout. Affections of the fasciae are frequent, and the plantar fasciae are especially liable to suffer, giving rise to flat-foot. Cases of pain in the heel, which cannot be referred to a short os calcis or to gout, are due to this cause. Another symptom is pain in the muscles, which may be mistaken for chronic myositis or rheumatism. When it attacks the lumbar fasciae, it is readily confounded with lumbago. The effusion into the joints rarely runs on to suppuration, although the complica¬ tion may occur in tuberculous subjects, and is common in pysemic gonorrhoea. The inflammation as a rule soon subsides, but after repeated attacks the joints may be irremediably damaged, and rendered useless by fibrous adhesions. The determination of the particular joint affected often depends on some accidental cause. A man plays football a few weeks after contracting a gonorrhoea, and the disease attacks his ankles; his friend, under similar circum¬ stances, carries a parcel to oblige a lady, and gets it in his hand. I have known it occur in a medical man in the right.
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