Infectious monoarthritis in the subtalarian joint due to N. gonorrhoae

: We report a case of gonococcal monoarthritis in the ankle of a young female. A blind tap of synovial fluid from the talocrural joint was without bacterial growth. The patient received anti-inflammatory treatment but did not improve. In an ultrasound-guided puncture of the subtalarian joint, the synovial fluid culture revealed N. gonorrhoeae. Due to the increasing incidence of gonorrhoea in Denmark, gonococcal monoarthritis should be suspected in any case of monoarthritis in young, sexually active patients. If small joints are affected, ultrasound-guided puncture is recommended to ensure correct microbiological diagnosis.