A 37-year-old man returned from a two-week holiday complaining of pain in the loins and painful swollen knees

NEET SS
#1

A 37-year-old man returned from a two-week holiday complaining of pain in the loins and painful swollen knees. On examination he was afebrile and had significant bilateral knee effusions. Mild penile erythema was also noted. Laboratory investigations showed.
Hb 15.6 g/dL
WBC 16.2 x 109/L
Neutrophils 14.1 x 109/L
ESR 65 mm/h
Rheumatoid factor 10 IU/L
Urinalysis No cells, casts or bacteria seen
What is the most likely diagnosis?

  1. Arthritis due to Neisseria gonorrhoeae infection

  2. Lymphogranuloma venereum

  3. Reactive arthritis

  4. Reitter’s syndrome

  5. Rheumatoid arthritis

View Explanation

Arthritis due to Neisseria gonorrhoeae infection

Gonococcal arthritis typically affects the knees and is the likeliest diagnosis in this scenario.