Gonorrheal arthritis is a distributed gonococcal infection with bacteria that occurs at a particular area or focus.

Gonorrheal arthritis is the result of having a distributed gonococcal infection caused by the organism, Neisseria gonorrheae. The condition is a complication of gonorrhea.

The onset of the condition is usually acute. The joints of the knee, wrist, ankle or elbow are usually affected. Signs and symptoms may include: fever; severe pain in the joints (polyarthralgias); and limited movement in one or more swollen, and tender joints. A skin rash with lesions consisting of small dead tissue skin elevations over the palms and soles of the feet is usually present. The skin around the joint is warm and red.

Diagnostic measures include: complete blood count (CBC), analysis and culture of the synovial fluid which is usually purulent and contains gonococci. Cultures of the synovial fluid are positive 50% of the time. Blood cultures are positive 30% of the time. Tests are also conducted to determine if chlamydia and syphilis are present. Cultures of the urethra, throat, and rectum are also done. The best yield cultures are from the genitourinary tract.

Treatment is started immediately. It may include intravenous (IV) antibiotics. Other measures may include: immobilization of the affected joint; passive range of motion (ROM) exercise; and quadriceps strengthening of the knee. Open drainage is rarely necessary except with hip involvement. Treatment of sexual partners is crucial. The person is advised to abstain from sexual activity until treatment is completed.

Residuals may include limitation of the joint due to destruction of the articular surfaces of the involved joint. Most persons can recover complete joint functioning. The person is re-screened for chlamydia or gonococcus 4 to 8 weeks after treatment.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• The disease must have become manifest to a degree of 10 percent or more within 1 year (for Hansen's disease (leprosy) and tuberculosis, within 3 years; multiple sclerosis, within 7 years) from the date of separation from service as specified in paragraph (a)(2) of this section. See 38 CFR 3.307(a)(3)  [chronic disease].

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Total plus 60% – Special Monthly Compensation (SMC).

• Other specified forms of arthropathy include, but are not limited to, Charcot neuropathic, hypertrophic, crystalline, and other autoimmune arthropathies.

• With the types of arthritis, diagnostic codes 5004 through 5009, rate the acute phase under diagnostic code 5002; rate any chronic residuals under diagnostic code 5003.