The diagnosis and management of common forms of arthritis in adults in Papua New Guinea.

Reactive arthritis is the leading cause of arthritis in Papua New Guinea, followed probably by gonococcal arthritis. Indomethacin and local hydrocortisone acetate are useful in the treatment of reactive arthritis. Refractory cases of reactive arthritis may be helped by weekly low-dose oral methotrexate or by long courses of doxycycline. When Neisseria gonorrhoeae is thought to be involved treatment should cover penicillinase-producing strains. Infective arthritis due to Staphylococcus aureus and Mycobacterium tuberculosis is less common but should be considered in all patients because prompt and specific treatment is required to avoid permanent damage.