Clutton Syndrome Definition and Meaning
The Clutton syndrome describes a bilateral swelling of large joints due to water retention. It is a mostly painless sequela of congenital syphilis that does not result in any additional restrictions for the patient. Both in diagnosis and in therapy, the identification and treatment of syphilis is primary and Cluton’s syndrome itself plays a subordinate role.
What is Clutton Syndrome?
Clutton syndrome is a bilateral thickening of the large synovial membrane within the large joints. Knee joints are particularly affected. This thickening is accompanied by effusions and swellings of the so-called Clutton joint. The cause is congenital, i.e. congenital, syphilis between the ages of eight and fifteen.
The Clutton syndrome that may result from this manifests itself, regardless of gender, mostly between the ages of nine and seventeen. The syndrome is named after the British Henry Hugh Clutton, who was the first to notice the connection between the disease and congenital syphilis. Another name for the syndrome is syphilitic arthritis.
The mandatory cause of Clutton syndrome is congenital syphilis. This usually arises from an infection of the unborn child in the twentieth week of pregnancy. If congenital syphilis breaks out during childhood or adolescence, Clutton syndrome can result.
Congenital syphilis presupposes that the mother of the unborn child has syphilis.
This can be before pregnancy. Infection during pregnancy is also possible and promotes vertical inheritance of the disease. The bacterial pathogen is usually transmitted sexually. Smallest injuries to the local mucous membranes are sufficient as transfer points. Transmission by blood transfusion or open wounds is also possible.
Symptoms, ailments & signs
Clutton syndrome is accompanied by various symptoms that can appear in different forms. For example, the pain that occurs during the course of the disease is different depending on the patient. In addition, there is swelling of the joints, but this does not affect functionality.
An important feature is the symmetrical swelling of the affected joints. Elbows and especially knee joints are particularly often affected. Some patients occasionally experience numbness in the extremities that adjoin the Clutton joint. Swelling of the lymph nodes is also possible, but not mandatory. In addition, there are the symptoms of congenital syphilis, which are primarily expressed in a change in the complexion of the skin.
Diagnosis & course
The disease is usually fever-free and can therefore be suspected primarily based on the symptoms in an anamnesis. The Hutchinsons triad, i.e. barrel-shaped incisors, hearing loss and corneal inflammation can also be possible signs, but are not necessarily pronounced. The Aquarian reaction in the blood is usually negative, but in some cases it can also be positive.
The aim of the diagnosis is to detect congenital syphilis. This is done via a newborn screening and subsequent blood tests. In combination with the typical symptoms, the diagnosis of Clutton syndrome can ultimately be made. Clutton syndrome breaks out as a result of active syphilis and supplements existing symptoms.
In addition, fluid accumulates in the joint capsules of the affected joints. This leads to swelling of the affected areas. However, the function of the joints is not impaired, so that patients do not lose their independence. Occasionally, however, pain can occur. In addition, the changed appearance can have an impact on the patient’s self-image and self-worth.
When should you go to the doctor?
As a rule, Clutton syndrome cannot be treated directly because it occurs as a consequence of other diseases. For this reason, treatment of the underlying disease is primarily necessary. However, the person concerned should then contact a doctor if there is severe swelling in the joints, although this swelling is not associated with pain and does not arise from a specific cause. The function of the joints is usually not affected by the swelling.
In addition, a doctor should be consulted if paralysis or sensitivity disorders occur in the extremities. The lymph nodes can also be swollen and indicate the disease. If this swelling does not go away on its own, a doctor should be consulted. The diagnosis and treatment can usually be carried out by a general practitioner and also leads to a positive course of the disease. The underlying condition that caused Clutton’s syndrome must also be treated.
Treatment & Therapy
Since the Clutton syndrome is a possible consequence of congenital syphilis, the therapy starts with this syphilis. Syphilis as such is usually treated with penicillin. In the event of intolerance, equivalent active ingredients are used for treatment. Depending on the stage of the disease, treatment lasts between ten and twenty-one days.
Depending on the severity, the treatment is carried out on an outpatient or inpatient basis via injections. An antibiotic treatment but promises no success in terms of the swelling of Clutton joints because the disease is too far advanced. The older the patient is, the more likely they are side effects such as fever or headache as part of the therapy.
Even after a successful recovery, regular follow-up checks are necessary to prevent the disease from breaking out again. Monthly checkups are recommended during pregnancy. If the syphilis is cured, something can be done about the water retention.
One drug option is diuretics, which are designed to combat swelling in the joints. But also a conscious diet with little salt, dehydrating teas, cold-blooded baths or elevating the affected joints can support decongestion. However, treatment in consultation with the doctor is advisable.
Outlook & forecast
In most cases, Clutton syndrome does not lead to any particular restrictions or complications in the life of the person concerned. For this reason, the disease is not treated in every case, as it does not pose any health risk to the person concerned.
In some cases, however, the swollen legs can lead to pain and thus reduce the quality of life of the person concerned. The joints are unaffected by this pain. Further treatment of Clutton syndrome usually only takes place after the successful treatment of syphilis.
For this reason, the course of the disease depends to a relatively large extent on the success of the treatment of the underlying disease. In most cases, they can be removed with the help of various therapies. Even after successful treatment of syphilis, patients are dependent on regular examinations and controls.
The course of Clutton syndrome is usually positive. The syndrome itself cannot be prevented in the first place if the underlying disease has already broken out. To protect yourself from syphilis, condoms should always be used during sexual intercourse. As a rule, the syndrome does not negatively affect the patient’s life expectancy.
Since congenital syphilis is the main trigger for Clutton syndrome, unprotected sex with syphilis patients should be avoided. Above all, condoms serve as protection against infection. Regular blood tests are recommended if the sexual partner changes frequently. This can help prevent syphilis during pregnancy.
Monthly prenatal examinations can also provide information about a possible infection of the unborn child. A patient cannot prevent Clutton syndrome per se, as it is predestined by the previous illness. No influence can be exerted on the possible outbreak of the syndrome.
Treatment for Clutton syndrome is straightforward and quick to complete. Immediately after the treatment, the sick have to take it easy. Sports and strenuous physical activity should be avoided for at least one to two weeks. Depending on the cause of the complaints, hygienic measures must also be taken to avoid infecting other people.
The follow-up care accordingly focuses on regular check-ups. The doctor will, among other things, check your blood counts and do a physical exam. Any complaints or after-effects of the treatment are discussed in a patient consultation. Finally, the doctor can prescribe suitable medication to taper the therapy painlessly.
If the disease progresses more seriously, further examinations may need to be carried out. These include, for example, X-ray examinations or the removal of a tissue sample. If the swelling recurs after treatment is complete, there may be another cause that has not yet been identified.
If necessary, the doctor will involve other specialists in the treatment. Elderly patients in particular are at risk of permanent joint damage. Then measures such as physiotherapy are also part of the aftercare. Sick children should always be treated as inpatients. Follow-up care must also take place in a hospital so that all necessary examinations can be carried out.
You can do that yourself
Since Clutton syndrome is a sequela of congenital syphilis, the underlying disease is treated first. Here the affected person can contribute to a faster recovery by strengthening his general constitution and his immune system. Sufficient sleep and a low-fat, vitamin and fiber-rich plant-based diet are beneficial.
On the other hand, a lot of fat and sugar, the regular consumption of meat and sausage products as well as too much alcohol and nicotine are disadvantageous. Those who feel stressed all the time should learn methods of coping with stress. Many health insurances offer free or heavily discounted nutrition courses or introductory courses in relaxation techniques such as yoga or autogenic training. It is also important to have enough physical exercise, whereby endurance sports such as cycling, swimming, hiking, walking or, in winter, cross-country skiing are good for your health.
Clutton syndrome itself can be relieved by taking diuretics. In the naturopathy are medicinal plants used with diuretic effect. Nettle tea is a classic. In pharmacies and health food stores, preparations based on parsley and asparagus are also offered. A low-salt diet can support the dehydrating effect.
Elevating the affected limbs as well as pouring cold water and compresses with acetic clay also promote swelling.