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Comparative Study of Acute Reiter Syndrome and Acute Gonococcal Arthritis

W. Clay McCord, MD; Kenneth M. Nies, MD; James S. Louie, MD

Arch Intern Med. 1977;137(7):858-862.

Abstract
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 mucocutaneous 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.

(Arch Intern Med 137:858-862, 1977)

Author Affiliations
From the Division of Rheumatology, Harbor General Hospital Campus of the University of California at Los Angeles School of Medicine, Torrance, Calif.

Footnotes
Accepted for publication Aug 10, 1976.

Presented in part at the 57th annual session of the American College of Physicians, Philadelphia, April 8, 1976.

Reprint requests to Division of Rheumatology, Harbor General Hospital, 1124 W Carson St, Torrance, Calif 90502 (Dr Nies).

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