Slide 1: The “sailor’s handshake” describes a maneuver in which two individuals clasp forearms. Beyond its function as a form of greeting, the handshake was thought to have a secondary purpose. Sailors used this handshake to “diagnose” infection with which disease?
Slide 2: Answer: Syphilis. historians believe the “sailor’s handshake” served as a “handy” way to assess for the presence of epitrochlear lymphadenopathy. This is a physical finding classically associated with treponemal disease.
Slide 3: Epitrochlear lymphadeno-what? There are several cases of syphilis in which epitrochlear lymphadenopathy ( a node on the medial side of the elbow) has been documented. However, this physical finding is NOT specific for treponemal infection, and is in fact frequently observed in non-syphilitic conditions.
Slide 4: Epitrochlear lymphadeno-what? In a review of patients with epitrochlear LAD, the most frequent diagnoses were: 1. CLL (44%), and 2. Infectious mononucleosis (24%). Other common conditions: HIV, sarcoidosis and other connective tissue diseases.
- O’Glasser AY, Kent CM. Misdirected by a Mass: Syphilis. Am J Med. 2016 Apr;129(4):379-81. Epub 2015 Dec 23.
- Ghafoor R, Anwar MI. A Young Boy with Persistent Nodules and Hoarseness: A Rare Presentation of Nodular Secondary Syphilis. J Coll Physicians Surg Pak. 2018 Mar;28(3):S37-S38.PMID 29482701
- Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc. 2000 Jul;75(7):723-32. PMID 10907389
Tags: infectious disease, lymphadenopathy, physical exam, syphilis