SYPHILITIC DISEASE
Syphilitic affections of joints are comparatively rare. As in
tuberculosis, the disease may be first located in the synovial membrane,
or it may spread to the joint from one of the bones.
In #acquired syphilis#, at an early stage and before the skin eruptions
appear, one of the large joints, such as the shoulder or knee, may be
the seat of pain--_arthralgia_--which is worse at night. In the
secondary stage, a _synovitis_ with serous effusion is not uncommon, and
may affect several joints. Syphilitic _hydrops_ is met with almost
exclusively in the knee; it is frequently bilateral, and is insidious in
its onset and progress, the patient usually being able to go about.
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