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.