Causes and risk factors
Clutton’s joint occurs in children with congenital syphilis. Lesion is a characteristic of tertiary syphilis. Congenital syphilis is caused as a result of a pregnant woman with syphilis passing the disease to the foetus through placenta. Treponema pallidum causes syphilis.
Clinical presentation
Clutton’s joint is a swelling of synovial membrane in the knee joints. The condition is bilateral. It presents with knee effusion. There is warmth and swelling over the knee joint. Toddlers may have a limp. Movements are unaffected and painless. Associated symptoms of congenital syphilis may be present such as failure to gain weight and fever. Irritability, no bridge to the nose [saddle nose], and watery discharge from the nose, etc. Small blisters on the palms and soles or copper-colored, flat, or bumpy rash on the face, palms, and soles are seen. Rash on the mouth, genitalia, and anus is present; severe congenital pneumonia can occur. Symptoms in older infants and young children may include abnormal notched and peg-shaped teeth called Hutchinson teeth, bone pain, blindness, clouding of the cornea, decreased hearing, or deafness. There are grey, mucus-like patches on the anus and outer vagina.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. If the disorder is suspected at the time of birth, the placenta will be examined for signs of syphilis. The mother may receive the following blood tests – FTA-ABS [fluorescent treponemal antibody absorbed test], RPR [rapid plasma reagin], VDRL [venereal disease research laboratory test]. An infant or child may have the following tests – x-ray of both knee joints as well as examination of synovial fluid from the affected joints is recommended.
Treatment
Treatment Involves aspiration of fluid from the joint with injection of corticosteroids in the articular cartilage of the affected joint. Medical treatment includes antibiotic course.
Other Modes of treatment
The other modes of treatment can also be effective in treating Clutton’s joint. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating Clutton’s joint.
