Today our group developed a great illness script for Gonococcal Arthritis:
Younger, sexually active person who presents with acute mono/oligoarthritis, migratory tenosynovitis, a vesicular pustular rash, and GU symptoms, who is found to be non-toxic, without destructive arthritis on imaging, and frequently with negative synovial gram stain/culture.
Other great learning points today:
- Synovial cultures for gonococcal arthritis are frequently falsely negative. (Positive 25-70% of the time)
- If clinical suspicion is high enough, you can do PCR testing, which is 76% sensitive and 96% specific.
For further reading regarding septic arthritis, consider reading AAFP's Approach to Septic Arthritis.