Gonococcal infection may disseminate systemically, including involvement of the musculoskeletal system.1-7 It has been estimated that gonococcal arthritis occurs in about 1% of patients with gonococcal infection.6 Clinical manifestations of disseminated gonococcal infection include skin lesions, arthritis affecting 1 or more joints, and tenosynovitis or periarthritis particularly affecting the dorsum of the wrist and hand and also the ankles.1 The primary site of infection may be asymptomatic.1 We present a case of a young female patient with septic wrist extensor tenosynovitis and shoulder arthritis that was diagnosed after sonographic examination.