Reactive Arthritis

Question 1

what is reactive arthritis

Answer 1

characterised by a sterile arthritis occurring after an extra-articular infection (commonly GI or urogenital).

Question 2

what is Reiter’s syndrome

Answer 2

triad of symptoms in reactive arthritis;

reactive arthritis, urethritis, conjunctivitis

Question 3

aetiology of reactive arthritis

Answer 3

associated with GI and urogenital infections

It is thought that initial activation of the immune system by a microbial antigen is followed by an autoimmune reaction that involves the skin, eyes and joints

Question 4

onset of presenting symptoms of reactive arthritis

Answer 4

3-30 days after infection

Question 5

presenting symptoms of reactive arthritis

Answer 5

Burning or stinging when passing urine (due to urethritis)

Arthritis

Low back pain (due to sacroiliitis)

Painful heels (due to enthesitis and plantar fasciitis)

Conjunctivitis

Question 6

risk factors for reactive arthritis

Answer 6

Male, HLA-B27, preceding GI/ urogenital infection

Question 7

investigations for reactive arthritis

Answer 7

stool cultures, microscopy, culture and sensitivity, cervical swabs,

blood tests (inflammatory markers)

radiological investigations (joint and pelvis X-ray)

Question 8

x-ray findings for reactive arthritis

Answer 8

joint- may be normal

pelvic X-ray may show sacroiliitis, and spinal X-rays may show squaring of vertebrae and syndesmophytes creating a “bamboo spine”, as in ankylosing spondylitis

Question 9

treatment of reactive arthritis

Answer 9

reactive arthritis are usually benign and resolve within weeks or months with NSAIDs and possibly corticosteroid injections.

It often recurs at least once for most patients, and a rare subset experience chronic and severe disease, requiring DMARDs to prevent joint damage