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THE ARTHRITIDES AND FOCAL INFECTION A CLINICAL CONTRIBUTION
VIRGIL P. GIBNEY
The Journal of Bone & Joint Surgery.  1920; 2:63-76 
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Abstract

1. A focus of infection should be diligently sought for in every case of Arthritis where tuberculosis, malignancy or trauma are not self-evident as causes or at least controlling factors.

2. A nonarticular arthritis demands the same painstaking investigation as does a polyarticular, for one can never tell when the former may merge into the latter.

3. While the finding of a focus and the proper handling of the same may not be followed sooner or later by relief, one can not assume that the infection is at an end.

4. The arrest of the infection does not mean that the exudates in and around a joint will disappear unless orthopaedic measures are employed to bring about resolution and restoration of function.

5. The finding of one focus does not mean that this is the only focus bearing on the case. It must be remembered that many organs are exposed to bacteria of a pus producing nature and that a careful study of these organs should be the rule.

I hesitate in publishing such a record of cases, no one of which seems to be complete. I simply love to get end results but in my reading and discussions before medical associations I get the impression that the arthritides are the most difficult we have in orthopaedic surgery; and while they naturally come under our care it would be well to rely on a "medical group." No one man can, in my judgment, conduct all of these cases to a successful issue.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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