Pathogenic Properties of Organisms Obtained From Joints in Chronic Arthritis.

Abstract

During recent years considerable evidence has been brought forward to show that chronic arthritis is due to streptococci. Forkner, Shands and Paston 1 obtained Streptococcus viridans from the joints in 11 of 63 cases; Cecil, Nicholls, and Stainsby 2 obtained cultures of atypical streptococci from the blood in 49 of 78 cases.

I wish to report the results of cultures from the joints of 50 cases. In most instances the cultures were made from material obtained by aspiration of the joints and periarticular tissues. From 10 to 20 cultures were made from each joint and several varieties of culture media were used. The media which proved most successful were Rosenow's glucose brain broth and hormone medium, made from beef heart.

Eighty-eight aspirations were performed on 50 cases. Of these 39 were chronic atrophic arthritis, 6 were chronic hypertrophic arthritis, and 5 were periarthritis of the shoulder. In addition to the aspirations, biopsies were performed 9 times in 7 cases and cultures were made from small bits of synovial membrane and cartilage. Positive cultures were obtained in 20 of 39 cases (51%) of atrophic arthritis, in 3 of 6 cases (50%) of hypertrophic, and in 2 of 5 cases (40%) of periarthritis of the shoulder. The organisms obtained were staphylococcus, 15 times, minute bacilli in masses, 4 times, mixed cultures of the above organisms, 10 times. In 2 of the mixed cultures short chained non-hemolytic streptococci were associated with either diptheroids or staphylococci. There was no tendency for any one organism to be associated with either the atrophic or hypertrophic form of the disease.

The organisms were as a rule slow growing in the original cultures, and in some cases did not appear until 3 weeks after the inoculation.