Document Detail

Arthritis in the highlands of Papua New Guinea.
MedLine Citation:
PMID:  8427514     Owner:  NLM     Status:  MEDLINE    
Acute polyarthritis is an important cause of morbidity in many tropical countries. Classification has often been difficult, with the term tropical polyarthritis used for those in whom a diagnosis could not be made. The implication that this is a distinct entity is probably incorrect, with likely causes being septic arthritis or post-infective reactive arthritis. This study aimed to determine the types of arthritis found in 43 patients (30 men) presenting consecutively to the Goroka Base Hospital in the Eastern Highlands of Papua New Guinea. Gonococcal arthritis was diagnosed in eight patients (six men) on the basis of isolation of Neisseria gonorrhoeae from the joint aspirate. In all cases the N gonorrhoeae was identified by the closed culture system on chocolate agar, but not always by routine plating. There were no specific clinical features that identified patients with a gonococcal septic arthritis. The remaining 34 patients had an undifferentiated oligoarthritis. The pattern of arthritis in men and women was of a lower limb pauciarticular arthritis with a predilection for the knee and ankle joints. A total of 30% of male patients had a history of urethral discharge and 44% of all patients had preceding diarrhoea. Arthritis was the only feature in 59% of patients and in 32% there was an associated enthesitis. In this study most patients had an oligoarthritis consistent with a reactive arthritis or a septic arthritis due to N gonorrhoeae. Broth inoculation of synovial fluid was the best method to isolate N gonorrhoeae, with standard methods for gonococcal isolation failing in some patients. It is recommended that the term 'tropical polyarthritis' is no longer used as it does not refer to a specific entity but consists of several known arthritides.
K D Pile; J E Richens; R M Laurent; K Bhatia; M L Prasad; T Lupiwa; B J Hudson; J Tapsall; R McPetrie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  52     ISSN:  0003-4967     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-03-01     Completed Date:  1993-03-01     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  49-53     Citation Subset:  IM    
Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia.
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MeSH Terms
Acute Disease
Arthritis / classification,  diagnosis*,  etiology
Arthritis, Infectious / diagnosis,  etiology
Gonorrhea / diagnosis
Papua New Guinea
Tropical Climate*

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