# A Painful Grip: A Case of Gonococcal Arthritis Masquerading as Wrist Pain

## TL;DR

This case report describes a rare instance of gonococcal arthritis affecting the wrist, emphasizing the importance of early diagnosis and treatment.

## Contribution

The report highlights wrist involvement in disseminated gonococcal infection, a less common presentation that can delay diagnosis.

## Key findings

- Gonococcal arthritis can present as wrist pain following trauma, mimicking other conditions.
- Early recognition and multidisciplinary management are crucial for optimal outcomes in DGI.
- Blood cultures may be negative, necessitating a high index of suspicion for diagnosis.

## Abstract

Disseminated gonococcal infection (DGI) is a rare complication of Neisseria gonorrhoeae (N. gonorrhoeae​​​​​​), and it can present variably, often making the diagnosis challenging. While it typically affects the knee, wrist involvement, as seen in this case report, has also been reported. DGI most commonly presents either as an arthritis-dermatitis syndrome or as purulent arthritis resembling septic arthritis. The diagnosis can be challenging, particularly when symptoms are atypical and initial imaging is unrevealing. Blood cultures may be negative in many cases, and hence, providers must consider DGI even in the absence of microbiologic confirmation. The management depends on the severity and varies from patient to patient. We describe a case of gonococcal arthritis of the wrist presenting after a traumatic accident at work. This report highlights the importance of recognizing the variable presentations of DGI and the need for early, multidisciplinary management to ensure optimal outcomes.