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Kevin Paul Speer

Clinical Faculty in the Department of Orthopaedic Surgery
Orthopaedic Surgery
Office hours 7:30 am to 5:00 pm monday thru friday  

Selected Publications


Hyperconcavity of the lumbar vertebral endplates in the elite football lineman.

Journal Article Am J Sports Med · September 2004 BACKGROUND: Hyperconcavity of the vertebral endplates is a previously unreported radiologic phenomenon. PURPOSE: To analyze hyperconcavity of the vertebral endplates with expansion of the disk space in pre-National Football League lineman and to determine ... Full text Link to item Cite

Thermal capsulorraphy of bilateral glenohumeral joints in a pediatric patient with Ehlers-Danlos syndrome.

Journal Article Arthroscopy · 2003 Ehlers-Danlos syndrome (EDS) is a heterogeneous collection of inherited connective tissue disorders characterized by hypermobility of the joints and hyperextensibility and fragility of the skin. For many patients, the hypermobile joints become problematic. ... Full text Link to item Cite

A biomechanical comparison of suture constructs used for coracoclavicular fixation.

Journal Article J South Orthop Assoc · 2003 There is no consensus regarding surgical treatment for severely dislocated acromioclavicular joints. Although many treatments are suture-based, the suture materials and resulting suture-bone constructs have been subjected to limited systematic evaluation. ... Link to item Cite

Radiographic findings associated with symptomatic rotator cuff tears.

Journal Article J Shoulder Elbow Surg · 2003 This study compared shoulder radiographs of patients with a documented rotator cuff tear with those of asymptomatic age-matched controls. Radiographs of 40 subjects with documented rotator cuff tears were evaluated along with similar films of 84 asymptomat ... Full text Link to item Cite

The effect of continuous cryotherapy on glenohumeral joint and subacromial space temperatures in the postoperative shoulder.

Journal Article Arthroscopy · September 2002 PURPOSE: The objective of this investigation was to determine the effect of continuous cryotherapy on glenohumeral joint and subacromial space temperatures in the postoperative shoulder. TYPE OF STUDY: Prospective, randomized, and controlled clinical trial ... Full text Link to item Cite

An electromyographic analysis of sumo and conventional style deadlifts.

Journal Article Med Sci Sports Exerc · April 2002 PURPOSE: Strength athletes often employ the deadlift in their training or rehabilitation regimens. The purpose of this study was to compare muscle activity between sumo and conventional style deadlifts, and between belt and no-belt conditions. METHODS: Six ... Full text Link to item Cite

Retroversion of the humerus in the throwing shoulder of college baseball pitchers.

Journal Article Am J Sports Med · 2002 BACKGROUND: Increased external rotation and decreased internal rotation have been noted to occur progressively in the throwing shoulder of baseball pitchers. HYPOTHESIS: Proximal remodeling of the humerus contributes to the rotational asymmetry between sho ... Full text Link to item Cite

The cosmetic appearance of the biceps muscle after long-head tenotomy versus tenodesis.

Journal Article Arthroscopy · 2002 PURPOSE: This study evaluates the cosmetic appearance of the biceps muscle after arthroscopic, intra-articular biceps tenotomy versus tenodesis by presenting subjective outcome results in patients with refractive bicipital pain. TYPE OF STUDY: Retrospectiv ... Full text Link to item Cite

An arthroscopic technique for confirming intra-articular subluxation of the long head of the biceps tendon: the ramp test.

Journal Article Arthroscopy · 2002 The purpose of this technical note is to introduce the ramp test and explain this arthroscopic technique. The ramp test is used to test the integrity of the soft tissue restraint to intra-articular subluxation of the long head of the biceps tendon. Injury ... Full text Link to item Cite

Interscalene brachial plexus block with continuous intraarticular infusion of ropivacaine.

Journal Article Anesth Analg · September 2001 Providing intraarticular analgesia with a continuous infusion of local anesthetic via a disposable infusion pump has gained popularity. Despite the prevalence of this technique, data comparing this method of analgesia to conventional regional anesthesia ar ... Full text Link to item Cite

Biomechanical analysis of the deadlift during the 1999 Special Olympics World Games.

Journal Article Med Sci Sports Exerc · August 2001 PURPOSE: Improper lifting techniques may increase injury risks and decrease performance. The aim of this study was to compare and contrast biomechanical parameters between sumo and conventional style deadlifts and between high- and low-skilled lifters who ... Full text Link to item Cite

Anatomy, pathophysiology, and biomechanics of shoulder instability.

Journal Article Orthop Clin North Am · July 2001 Instability in the athlete presents a unique challenge to the orthopaedic surgeon. A spectrum of both static and dynamic pathophysiology, as well as gross and microscopic histopathology, contribute to this complex clinical continuum. Biomechanical studies ... Full text Link to item Cite

Assessment of instability of the long head of the biceps tendon by MRI.

Journal Article Skeletal Radiol · April 2001 OBJECTIVE: To determine whether MRI can identify instability of the long head of the biceps tendon (LBT) in the rotator interval. DESIGN AND PATIENTS: A retrospective review was carried out of 19 patients, all arthroscopically examined, nine of whom had su ... Full text Link to item Cite

Focal articular cartilage lesions of the superior humeral head: MR imaging findings in seven patients.

Conference AJR Am J Roentgenol · February 2001 OBJECTIVE: We describe the MR imaging findings of focal articular cartilage lesions of the superior humeral head and the clinical features in seven patients. CONCLUSION: Focal articular cartilage lesions of the superior humeral head are rare lesions that m ... Full text Link to item Cite

The efficacy of continuous cryotherapy on the postoperative shoulder: a prospective, randomized investigation.

Journal Article J Shoulder Elbow Surg · 2001 This prospective, randomized investigation evaluated the efficacy of cryotherapy on subjective responses after both open and arthroscopic procedures on the shoulder. Seventy patients were randomly assigned to one of two study groups: (1) continuous cryothe ... Full text Link to item Cite

Acromial morphotype in the young asymptomatic athletic shoulder.

Journal Article J Shoulder Elbow Surg · 2001 Several studies have documented an association between the type III acromion and rotator cuff tears. However, controversy exists as to whether the shape of the acromion is an innate anatomic characteristic. The purpose of this study was to evaluate the pre ... Full text Link to item Cite

Valgus laxity of the ulnar collateral ligament of the elbow in collegiate athletes.

Journal Article Am J Sports Med · 2001 In this investigation, we determined the patterns of valgus laxity and acquired valgus laxity of the ulnar collateral ligament in the elbows of collegiate athletes involved in overhead and nonoverhead sports. Acquired valgus laxity of the elbow is defined ... Full text Link to item Cite

Function of the long head of the biceps at the shoulder: electromyographic analysis.

Journal Article J Shoulder Elbow Surg · 2001 The purpose of this study was to delineate, through electromyographic analysis, the function of the long head of the biceps at the shoulder. Ten shoulders were examined with dynamic electromyography. The long head of the biceps was instrumented with thin w ... Full text Link to item Cite

Interscalene brachial plexus block with a continuous catheter insertion system and a disposable infusion pump.

Journal Article Anesth Analg · December 2000 Continuous interscalene brachial plexus blockade traditionally requires a hospital stay for local anesthetic infusion, and achieving consistent catheter insertion may be difficult. Incorporating long-acting pain relief from a continuous peripheral nerve bl ... Full text Link to item Cite

Increased T2 signal intensity in the distal clavicle: incidence and clinical implications.

Conference Skeletal Radiol · December 2000 OBJECTIVE: The objectives of the current study were (1) to quantify the incidence of increased T2 signal in the distal clavicle and (2) to assess the clinical significance of this finding in patients with chronic acromioclavicular (AC) joint pain. DESIGN A ... Full text Link to item Cite

The relationship of age, gender, and degenerative changes observed on radiographs of the shoulder in asymptomatic individuals.

Journal Article J Bone Joint Surg Br · November 2000 Radiographs of the shoulders of 84 asymptomatic individuals aged between 40 and 83 years were evaluated to determine changes in 23 specific areas. Two fellowship-trained orthopaedic radiologists graded each area on a scale of 0 to II (normal 0, mild change ... Full text Link to item Cite

A three-dimensional biomechanical analysis of sumo and conventional style deadlifts.

Journal Article Med Sci Sports Exerc · July 2000 PURPOSE: Strength athletes often employ the deadlift in their training or rehabilitation regimens. The purpose of this study was to quantify kinematic and kinetic parameters by employing a three-dimensional analysis during sumo and conventional style deadl ... Full text Link to item Cite

The MR imaging appearance of longitudinal split tears of the peroneus brevis tendon.

Journal Article Foot Ankle Int · June 2000 PURPOSE: Longitudinal split tears of the peroneus brevis tendon have been increasingly reported as a source of lateral ankle pain and disability. MR imaging is useful in identifying the appearance of longitudinal split tears of the peroneus brevis tendon t ... Full text Link to item Cite

Shoulder muscle activation during aquatic and dry land exercises in nonimpaired subjects.

Journal Article J Orthop Sports Phys Ther · April 2000 STUDY DESIGN: Randomized, single blind experimental design using electromyography to measure shoulder muscle activation in nonimpaired subjects. OBJECTIVES: To compare the muscle activation of rotator cuff and shoulder synergists during rehabilitation exer ... Full text Link to item Cite

Effects of throwing overweight and underweight baseballs on throwing velocity and accuracy.

Journal Article Sports Med · April 2000 The purpose of this review is to determine how throwing overweight and underweight baseballs affects baseball throwing velocity and accuracy. Two studies examined how a warm-up with overweight baseballs affected throwing velocity and accuracy of 5 oz regul ... Full text Link to item Cite

The intra-articular component of the subscapularis tendon: anatomic and histological correlation in reference to surgical release in patients with frozen-shoulder syndrome.

Journal Article Arthroscopy · April 2000 Recently, arthroscopic surgical techniques have been reported for release of glenohumeral capsular contractures in selected patients with frozen-shoulder syndrome. The purpose of the current study was to assess the anatomy and histology of the subscapulari ... Full text Link to item Cite

Anatomy, pathophysiology, and biomechanics of shoulder instability

Journal Article Operative Techniques in Sports Medicine · January 1, 2000 Instability in the athlete presents a unique challenge to the orthopaedic surgeon. A spectrum of both static and dynamic pathophysiology, as well as gross and microscopic histopathology, contribute to this complex clinical continuum. Biomechanical studies ... Full text Cite

Magnetic resonance imaging findings in anterolateral impingement of the ankle.

Journal Article Skeletal Radiol · January 2000 OBJECTIVE: To demonstrate the MR imaging findings of anterolateral impingement (ALI) of the ankle. DESIGN AND PATIENTS: Nine patients with a history of ankle inversion injury and chronic lateral ankle pain were imaged with MR imaging, and the findings corr ... Full text Link to item Cite

Accelerated Post-Operative Management of Shoulder Injuries

Journal Article Athletic Therapy Today · July 1999 Full text Cite

Intra- and interobserver reproducibility of the shoulder laxity examination.

Journal Article Am J Sports Med · 1999 The present study evaluates the inter- and intraobserver reproducibility of clinical examination of glenohumeral laxity in the unanesthetized shoulder. Forty-three asymptomatic Division I collegiate athletes underwent bilateral shoulder laxity examination ... Full text Link to item Cite

An arthroscopic technique for treating patients with frozen shoulder.

Journal Article Arthroscopy · 1999 Forty-three patients with a diagnosis of primary or secondary frozen shoulder who had symptoms for an average of 12 months and failed conservative treatment of at least 12 weeks of physical therapy, were treated with an arthrosopic capsular release. On com ... Full text Link to item Cite

The low anterior five-o'clock portal during arthroscopic shoulder surgery performed in the beach-chair position.

Journal Article Am J Sports Med · 1999 We evaluated the difficulty, accuracy, and safety of establishing a low anterior 5-o'clock portal for anterior capsulolabral repair in patients positioned in the beach-chair position during shoulder arthroscopy. An initial 5-o'clock portal was created usin ... Full text Link to item Cite

A comparison of 0.5% bupivacaine, 0.5% ropivacaine, and 0.75% ropivacaine for interscalene brachial plexus block.

Journal Article Anesth Analg · December 1998 UNLABELLED: The onset time and duration of action of ropivacaine during an interscalene block are not known. The potentially improved safety profile of ropivacaine may allow the use of higher concentrations to try and speed onset time. We compared bupivaca ... Full text Link to item Cite

Shoulder instability and impingement in throwing athletes.

Journal Article Med Sci Sports Exerc · April 1998 The glenohumeral articulation maintains a fine balance between mobility and stability. In the throwing athlete, this balance is stressed from the repetitive microtrauma incurred to achieve peak performances. The presentation of shoulder pain in the throwin ... Full text Link to item Cite

Frozen shoulder syndrome: diagnostic and treatment strategies in the primary care setting.

Journal Article Med Sci Sports Exerc · April 1998 The term "frozen shoulder" has been used to describe an array of clinical conditions. The authors consider a patient as meeting the criteria of primary or secondary frozen shoulder syndrome if he/she has a clinical history of worsening painful shoulder mot ... Full text Link to item Cite

Frozen shoulder syndrome: diagnostic and treatment strategies in the primary care setting

Journal Article MEDICINE AND SCIENCE IN SPORTS AND EXERCISE · April 1, 1998 Link to item Cite

Shoulder instability and impingement in throwing athletes

Journal Article MEDICINE AND SCIENCE IN SPORTS AND EXERCISE · April 1, 1998 Link to item Cite

Acute brachial neuritis (Parsonage-Turner syndrome): MR imaging appearance--report of three cases.

Journal Article Radiology · April 1998 Magnetic resonance (MR) imaging findings in three patients with acute onset of neuritic shoulder pain and weakness included high signal intensity in supra- and infraspinatus muscles (n = 2), partial involvement of infraspinatus muscle (n = 1) and of deltoi ... Full text Link to item Cite

Posterior labral injury in contact athletes.

Journal Article Am J Sports Med · 1998 Nine athletes (seven football offensive linemen, one defensive lineman, and one lacrosse player) were found at arthroscopy to have posterior labral detachment from the glenoid. In our series, this lesion is specific to contact athletes who engage their opp ... Full text Link to item Cite

Femoral stress fractures.

Journal Article Clin Sports Med · April 1997 Stress fractures are common overuse injuries attributed to the repetitive trauma associated with vigorous weightbearing activities. A high index of suspicion is necessary to diagnose stress fractures of the femur because the symptoms may be vague. The prec ... Full text Link to item Cite

Technical considerations for electromyographic research on the shoulder.

Journal Article Clin Orthop Relat Res · February 1997 This study compared 2 methods of indwelling bipolar electrode insertion. One method used a single needle for the insertion of both wire leads, and the second method used 2 needles for the independent insertion of both leads at a specified interdetection di ... Link to item Cite

The weighted abduction Grashey shoulder method.

Journal Article Radiol Technol · 1997 The Grashey shoulder position is used to demonstrate damage to the glenohumeral joint caused by osteoarthritis, sclerosis, tumors, fractures, osteophytes and cystic changes. However, it can be difficult to assess loss of articular cartilage using the Grash ... Link to item Cite

Reliability and reproducibility of radiographic interpretation of proximal humeral fracture pathoanatomy.

Journal Article J Shoulder Elbow Surg · 1997 Recent studies have demonstrated inconsistencies in the use of certain images for classifying proximal humerus fractures. Our purpose was to determine whether three-dimensional computed tomography or the level of expertise of the observers would improve th ... Full text Link to item Cite

An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack.

Journal Article J Bone Joint Surg Am · December 1996 Arthroscopically assisted repair of the anterior aspect of the labrum with use of a bioabsorbable tack was performed in fifty-two consecutive patients who had chronic anterior instability of the shoulder. The average age of the patients was twenty-eight ye ... Full text Link to item Cite

Optimal normalization tests for shoulder muscle activation: an electromyographic study.

Journal Article J Orthop Res · July 1996 To accurately compare electromyographic data from different muscles and different subjects, it is necessary to normalize the integrated data obtained from each muscle. The purpose of this study was to identify the manual muscle testing positions that elici ... Full text Link to item Cite

Glenohumeral translation in the asymptomatic athlete's shoulder and its relationship to other clinically measurable anthropometric variables.

Journal Article Am J Sports Med · 1996 To determine the degree of shoulder translation in uninjured athletes, we examined 76 Division I collegiate athletes (44 women and 32 men) for passive range of motion in both shoulders and for knee and elbow hyperextension. Translation was based on a scale ... Full text Link to item Cite

The manual muscle examination for rotator cuff strength. An electromyographic investigation.

Journal Article Am J Sports Med · 1996 The electromyographic activity of eight muscles of the rotator cuff and shoulder girdle (supraspinatus, infraspinatus, subscapularis, pectoralis, latissimus dorsi, and the anterior, middle, and posterior deltoid) was measured from the nondominant shoulders ... Full text Link to item Cite

Acute dislocation of the patella. A correlative pathoanatomic study.

Journal Article Am J Sports Med · 1996 The objective of our study was to elucidate the characteristic pathoanatomy associated with patellar dislocation and report the preliminary results of early surgical repair. Twenty-three patients with documented patellar dislocation had standard radiograph ... Full text Link to item Cite

The evaluation of pelvic injury in the female athlete.

Journal Article Sports Med · December 1995 The differential diagnosis of pelvic pain and possible injury in the female athlete is quite broad and must include gastrointestinal and genitourinary aetiologies, as well as musculoskeletal injuries. These considerations reflect the anatomical complexity ... Full text Link to item Cite

Anatomy and pathomechanics of shoulder instability.

Journal Article Clin Sports Med · October 1995 The mechanisms contributing to glenohumeral stability are complex and varied. The rotator cuff is the dominant contributor to stability through the mid arcs of motion through concavity compression. At the end ranges of motion, the capsular ligamentous syst ... Link to item Cite

Gout as a source of sesamoid pain.

Journal Article Foot Ankle Int · October 1995 Isolated gout of a great toe sesamoid has not been described previously. We present a case of gout of the medial sesamoid in a young athlete. Because a diagnosis is often elusive in patients with sesamoid pain, it is possible that other cases of gout of a ... Full text Link to item Cite

Arthroscopic fixation of superior labral lesions using a biodegradable implant: a preliminary report.

Journal Article Arthroscopy · April 1995 Twenty-two patients were treated for symptomatic lesions of the superior glenoid labrum in association with instability of the tendinous insertion of the long head of the biceps brachii. A biodegradable implant was used to fix the labrum to the bony glenoi ... Full text Link to item Cite

Multidirectional instability: current concepts.

Journal Article J Shoulder Elbow Surg · 1995 Multidirectional instability (MDI) of the shoulder is a complex problem that is not yet well understood. Instability in several directions is termed MDI, but the precise definition, classification, cause, and optimal method of treatment remains elusive. Th ... Full text Link to item Cite

Patterns of glenohumeral motion loss in patients with chronic rotator cuff tendinopathy and subacromial impingement.

Journal Article J South Orthop Assoc · 1995 Passive glenohumeral motion loss can occur in patients with chronic rotator cuff tendinopathy and subacromial impingement. It is essential for the clinician when evaluating patients with rotator cuff symptoms and subacromial impingement to assess for conco ... Link to item Cite

Strategies for an anterior capsular shift of the shoulder. A biomechanical comparison.

Journal Article Am J Sports Med · 1995 We evaluated the effect of two different anterior capsular shift strategies on load-induced multidirectional glenohumeral motion. Nine cadaveric shoulders were tested on a special test apparatus in which three motions were constrained but which allowed sim ... Full text Link to item Cite

Observations on the injury mechanism of anterior cruciate ligament tears in skiers.

Journal Article Am J Sports Med · 1995 The purpose of this study was to demonstrate the uniqueness of the injury mechanism for acute complete tears of the anterior cruciate ligament in recreational alpine skiers by using patterns of osseous injury as detected by magnetic resonance imaging. We t ... Full text Link to item Cite

Reliability of radiographic assessment of acromial morphology.

Journal Article J Shoulder Elbow Surg · 1995 The most widely used radiographic classification system for acromial morphology identifies three distinct acromial shapes: type I (flat), type II (curved), and type III (hooked). The purpose of this study was to measure the interobserver and intraobserver ... Full text Link to item Cite

Biomechanical evaluation of a simulated Bankart lesion.

Journal Article J Bone Joint Surg Am · December 1994 The purpose of this study was to determine the effect of sectioning of the anterior part of the inferior glenohumeral ligament (a simulated Bankart lesion) on load-induced multidirectional glenohumeral motion. Nine fresh, intact cadaveric shoulders were te ... Full text Link to item Cite

The deltoid sign.

Journal Article Anesth Analg · July 1994 Full text Link to item Cite

An evaluation of the shoulder relocation test.

Journal Article Am J Sports Med · 1994 The purpose of this study was to evaluate the sensitivity, specificity, negative and positive predictive values, and accuracy of the shoulder relocation test in 100 patients who underwent shoulder surgery. Based on operative data and examination under anes ... Full text Link to item Cite

Longitudinal rupture of the peroneal tendons.

Journal Article Am J Sports Med · 1993 To determine more precisely the injury mechanism of the peroneal tendon longitudinal tear, we studied 15 cadaveric lower extremities. Our study was motivated by our observation from a retrospective study of athletes treated by one surgeon (FHB) over a 17-y ... Full text Link to item Cite

Radiographic imaging of muscle strain injury.

Journal Article Am J Sports Med · 1993 We reviewed our experience with computed tomography and magnetic resonance imaging of acute muscle strain injury. We imaged 50 athletes (average age, 28 years; range, 17 to 42) who had an acute muscle strain involving either the adductor, hamstring, quadri ... Full text Link to item Cite

Osseous injury associated with acute tears of the anterior cruciate ligament.

Journal Article Am J Sports Med · 1992 Multiplanar spin-echo magnetic resonance imaging was performed on 54 patients with acute complete anterior cruciate ligament tears. Imaging was done within 45 days of index anterior cruciate ligament injury. Spin-echo T1- and T2-weighted images were used t ... Full text Link to item Cite

Tetracycline labeling of the femoral head following acute intracapsular fracture of the femoral neck.

Journal Article Clin Orthop Relat Res · June 1991 The purpose of this study was to assess the utility of tetracycline hydrochloride (HCl) labeling of the femoral head following acute intracapsular fracture of the femoral neck to indirectly assess femoral head viability and vascularity. A standard labeling ... Link to item Cite

Arthroscopic subacromial decompression: results in advanced impingement syndrome.

Journal Article Arthroscopy · 1991 A study group composed of 25 shoulders in 24 patients underwent arthroscopic subacromial decompression for advanced impingement syndrome. There were no full thickness rotator cuff tears, biceps tendon ruptures, significant acromioclavicular arthrosis, or e ... Full text Link to item Cite

Magnetic resonance imaging of traumatic knee articular cartilage injuries.

Journal Article Am J Sports Med · 1991 The purpose of this study was to assess the sensitivity of magnetic resonance imaging in determining the presence of articular cartilage injuries of the knee with arthroscopy as the standard for comparison. Forty-nine articular cartilage lesions were docum ... Full text Link to item Cite

The effects of exposure of articular cartilage to air. A histochemical and ultrastructural investigation.

Journal Article J Bone Joint Surg Am · December 1990 The effects of exposure of articular cartilage to air and the potential for reversibility of the histological and ultrastructural changes that were produced by this exposure were investigated in the knee joint of the rabbit. After a medial parapatellar art ... Link to item Cite

The prolonged burner syndrome.

Journal Article Am J Sports Med · 1990 Over the course of a single football season, six players evaluated by the medical staff had burners that displayed a prolonged neurologic recovery. These players were examined and subsequently evaluated with isokinetic testing and electrodiagnostic studies ... Full text Link to item Cite

Magnetic resonance imaging of the femoral head after acute intracapsular fracture of the femoral neck.

Journal Article J Bone Joint Surg Am · January 1990 In fifteen patients who had a subcapital fracture of the femoral neck (twelve displaced fractures and three non-displaced fractures), magnetic resonance imaging of the femoral head was done with two-dimensional Fourier transform spin-echo technique within ... Link to item Cite

MAGNETIC-RESONANCE-IMAGING OF THE FEMORAL-HEAD AFTER ACUTE INTRACAPSULAR FRACTURE OF THE FEMORAL-NECK

Journal Article JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME · 1990 Full text Cite

INJURIES TO THE BRACHIAL-PLEXUS IN FOOTBALL PLAYERS

Journal Article SOUTHERN MEDICAL JOURNAL · September 1, 1988 Link to item Cite

Neisseria gonorrhoeae foot abscess. A case report.

Journal Article Clin Orthop Relat Res · September 1988 A cutaneous abscess involving Neisseria gonorrhoeae is extremely rare outside the perineum. Such remote lesions are a result of disseminated gonococcal disease. A 12-year-old girl with arthrogryposis multiplex congenita developed a gonococcal abscess on th ... Link to item Cite