Reactive Arthritis

Question 1

what is reactive arthritis?

Answer 1

synovitis in the joints as a reaction to a recent infective trigger (Reiter syndrome)

Question 2

symptoms of reactive arthritis

Answer 2

acute monoarthirtis (angle joint in lower limb - knee)
warm, swollen and painful joint

Question 3

differential diagnosis for reactive arthritis

Answer 3

septic arthritis

*in reactive arthritis there is no infection it is a reaction triggered by infection

Question 4

what are the most common triggers for reactive arthritis?

Answer 4

gastroeneteritis
STI- chlamydia, gonorrhoea (gonoccoal septic arthritis)

link to HLA-B27

Question 5

what is reactive arthritis associated with?

Answer 5

Bilateral conjunctivitis (non-infective)
Anterior uveitis
Circinate balanitis is dermatitis of the head of the penis

can’t SEE, can’t PEE, can’t climb a tree

Question 6

how to manage reactive arthritis

Answer 6

“hot joint policy”
give antibiotics until the possibility of septic arthritis is excluded. aspirate and gram stain, culture and sensiivity

aspirate to be sent for crystal examination to look for gout and pseudogout

medical:
NSAIDs
steroid injection
systemic steroids

most resolve in 6 months and do not recur
if recurrent- DMARD or anti TNF