Clutton's joints

A medical condition associated with congenital syphilis

Clutton's joints refer to a specific manifestation of congenital syphilis characterized by symmetrical swelling of the knee joints. This condition is named after the British surgeon Henry Hugh Clutton, who first described it in the late 19th century.

Pathophysiology

Clutton's joints occur as a result of syphilitic infection transmitted from mother to child during pregnancy. The Treponema pallidum bacterium, responsible for syphilis, can cross the placenta and infect the developing fetus, leading to a range of congenital abnormalities, including joint involvement.

Clinical Presentation

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Clutton's joints in a child with congenital syphilis

The hallmark of Clutton's joints is the painless swelling of the knees, which typically presents in children between the ages of 5 and 8 years. The swelling is usually bilateral and symmetrical, distinguishing it from other causes of joint effusion in children. Despite the significant swelling, the condition is generally not associated with pain or tenderness.

Diagnosis

The diagnosis of Clutton's joints is primarily clinical, supported by a history of maternal syphilis or positive serological tests for syphilis in the child. X-ray imaging of the affected joints may show characteristic changes, but these are not specific to syphilis. Serological tests such as the VDRL or RPR can confirm the presence of syphilis.

Treatment

The primary treatment for Clutton's joints is the administration of penicillin, which is effective in treating syphilitic infections. Early treatment can prevent further complications and resolve the joint swelling. In some cases, additional supportive care may be required to manage symptoms.

Prognosis

With appropriate antibiotic treatment, the prognosis for children with Clutton's joints is excellent. The joint swelling typically resolves without any long-term sequelae. However, untreated congenital syphilis can lead to more severe complications, emphasizing the importance of early diagnosis and treatment.

Related pages

• Congenital syphilis
• Henry Hugh Clutton
• Syphilis
• Treponema pallidum