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In patients with gonorrhea, the examination finding that is uncommon is purulent discharge. Gonorrhea typically presents with a purulent or mucopurulent discharge from the urethra in men and can also cause cervicitis in women, leading to vaginal discharge. However, this finding can vary, and some patients may not exhibit noticeable discharge.

In contrast, tender lymphadenopathy, joint pain, and hematuria can occur in the context of disseminated gonococcal infection. Tender lymphadenopathy might result from the body's immune response to the primary infection, whereas joint pain can signify septic arthritis, a complication of gonorrheal infection. Hematuria, although less common, can occur if the infection spreads to the urinary tract.

Understanding the clinical manifestations of gonorrhea helps in recognizing the varying presentations and potential complications associated with the infection, emphasizing that purulent discharge is a commonly noted feature rather than uncommon.