The term, infective arthritis, is applied to a group of diseases in which there are inflammatory changes in one or more joints of the body, known to be, or believed to be, due to a systemic infecting agent. In some of these the specific infecting agent is known; in others it is unknown or of a doubtful nature.The material presented in this study is not a representative cross-section of such joint infections as they occur in the ordinary population or even among the personnel of the Armed Forces. Our work is concerned with the diagnosis and. treatment of the venereal diseases and, as might be expected, patients with arthritis who are sent to us for treatment or who are found by us in the routine of ordinary practice, are those with gonorrhoea, those who have a history of past gonorrhoea or those who present evidence of some other infection of the genitourinary tract. Yet there were cases in our series in which the evidence of genital infection was obtained only by specialized examination, and which in other hands might certainly have received the diagnostic label, " rheumatoid arthritis ". In undertaking the treatment of such patients, we were fortunate in that many of them came under our care earlier in the course of the. disease than might be expected in civil life, in which the premium on absolute physical fitness is less and force of economic circumstances may delay the application of in-patient treatment.
Rheumatoid arthritisThe subject of the disease, or group of diseases, which is known as rheumatoid arthritis and by other names, is not one upon which we can claim expert knowledge, and is therefore uncertain ground upon which we are unwilling to linger. It is, however, a subject which touches the fringe of venereology, leaving a " no man's land " of some doubt and difficulty. Study of some of the recent literature of the subject does little to clarify the problem. Sclater has analysed the case records of 388 cases of rheumatoid arthritis which occurred in Scotland. He gives the criteria on which the diagnosis was made as follows.(1) The presence of persistent swelling of the periarticular tissues in the region of more than one joint.(2) The involvement, either primarily or subsequently, of the wrist, metacarpophalangeal joints, or interphalangea1 joints.(3) The presence of muscular wasting.(4) Radiological evidence compatible with a diagnosis of rheumatoid arthritis.
