[5] Reactive Arthritis Flashcards
What is reactive arthritis?
Reactive arthritis is a form of arthritis that can cause inflammation and pain in the joints. It is thought to occur as a ‘reaction’ to an infection that started elsewhere in the body
Other than joints, where can reactive arthritis affect?
- Skin
- Eyes
- Bladder
- Genitals
- Mucus membranes
Where does the infection that triggers reactive arthritis typically come from?
Genitourinary or gastrointestinal tract
When does reactive arthritis occur?
After exposure to, or infection caused by, certain types of bacteria
What bacteria can cause reactive arthritis?
- Chlamydia
- Salmonella
- Shigella
- Yersina
- Campylobacter
Does everyone that comes into contact with the causative bacteria get reactive arthritis?
No
Who is more likely to develop reactive arthritis after exposure to certain bacteria?
Those who test positive for HLA-B27
How long after a known infection does reactive arthritis typically occur?
1-3 weeks
What is the mechanism of interaction between infecting organism and host in reactive arthritis?
Unknown, however it is thought to be autoimmune
Describe the clinical pattern of reactive arthritis
It commonly consists of inflammation of fewer than 5 joints, which often include the knee or sacroiliac joint
What are the joint symptoms of reactive arthritis?
- Pain
- Swelling
- Stiffness
What are the joint symptoms of reactive arthritis often coupled with?
Other characteristic symptoms (previously referred to as Reiters syndrome) of conjunctivitis and urethritis
What are the urethral symptoms of reactive arthritis?
Dysuria and increased frequency
These symptoms often present first
What are the ocular symptoms of reactive arthritis?
- Redness of eyes
- Eye pain and irritation
- Blurred vision
Eye symptoms typically occur early in the course, and may come and go
Other than joint, eye, and urethral symptoms, what symptoms might be present in reactive arthritis?
- Skin rashes that commonly appear as thickened red or brown spots
- Swelling of involved finger and toes, causing ‘sausage digits’
- Fingernail and toenail changes
- Fever and chills
- Enthesitis
- Genital sores
How is a diagnosis of reactive arthritis made?
On the basis of clinical history, as well as investigations to support diagnosis and rule out similar conditiosn
What tests may be done in the investigation of reactive arthritis?
- Swabs of urethra, cervix, and throat
- Testing for chlamydia
- Blood tests
What is the importance of swabs in the investigation of reactive arthritis?
They can aid diagnosis and determine the causative organisms
Why is testing for chlamydia important in reactive arthritis?
Studies have shown that early treatment of chlamdyia may reduce the progression of the disease
How can blood tests results aid diagnosis in reactive arthritis?
- ESR and CRP should be increased
- Presence of rheumaroid factor or anti-nuclear antibodies indicate other forms of arthritis
What is the main goal of treatment in reactive arthritis?
To identify and eradicate the underlying infectious source with appropriate antibiotics if still present
Does treatment of underlying infection always make a difference in reactive arthritis?
No
What treatments options are available for symptomatic relief in reactive arthritis?
- Analgesics, particularly NSAIDs
- Steroids, sulfasalazine, and immunosuppressant’s may be needed for patients with severe reactive symptoms that do not respond to any other treatment
