Osteoarthritis and Reactive Arthritis Flashcards
Define reactive arthritis.
Sterile inflammation in joints following infection, especially urogenital and gastrointestinal infections
(not to be confused with septic inflammation)
State a urogenital infection that can cause reactive arthritis.
Chlamydia trachomatis
Give some examples of gastrointestinal infections that are associated with reactive arthritis.
Shigella
Salmonella
Campylobacter
What subset of the population does reactive arthritis tend to occur in?
It occurs mainly in young adults with a genetic predisposition and an environmental trigger
How long after the infection does the reactive arthritis tend toappear?
1-4 weeks
Describe the features of the arthritis in reactive arthritis.
It is an asymmetrical arthritis that occurs in relatively few joints (rheumatoid = symmetrical + many joints involved)
Reactive arthritis can cause enthesopathy. Which entheses are likely to get affected and what symptoms will that cause?
Achilles tendonitis
Dactylitis
Metatarsalgia (painful feet because of inflammation of the palmar fascia)
What is a very common feature of seronegative spondyloarthropathies?
Sacro-iliitis
State some extra-articular features of reactive arthritis?
Sterile conjunctivitis
Sterile urethritis
Circinate balanitis
Keratoderma blennorhagicum
What is the triad of symptoms that can be used to describereactive arthritis?
Reiter’s syndrome – joint inflammation + urethritis + conjunctivitis
Where can you get spondylitis in rheumatoid arthritis?
Only At the atlanto-axial joint.
MAIN IDEA: Rheumatoid does not involve spondylitis in general
Describe the main differences between rheumatoid arthritis and reactive arthritis.
slide 6
What is the main danger in septic arthritis?
The bacteria produce metalloproteinases that can rapidly degrade thearticular cartilage
What are the main differences between septic arthritis and reactive arthritis?
Septic arthritis has a positive synovial fluid culture
It is treated with antibiotics and may even require joint lavage
Reactive arthritis involves infection ELSEWHERE (not within the joint) and is followed by arthritis. (hence called sterile inflammation)
Describe the treatment of reactive arthritis.
It usually resolves by itself
NSAIDs and corticosteroids to control pain and inflammation.
symptomatic treatment of extra-articular manifestations