Reactive Arthritis Flashcards
what is reactive arthritis
arthritis (~4wks) post-infection where organism cannot be recovered from joint
a hla-b27 associated seronegative spondyloarthropathy
what is the classic triad in reactive arthritis?
urethritis (-> dysuria)
conjunctivitis (-> eye discharge)
arthritis (-> painful swelling of joint)
what dermatological features can be seen in reactive arthritis?
keratoderma blennorrhagica - waxy, scaly yellow/brown papules on palms and soles
circinate balanitis - painless vesicles on coronal margin of prepuce
how long do sx last for reactive arthritis?
~4-6 months
epidemiology of reactive arthritis?
post-sti form more common in men
post-dysenteric form equal sex incidence
organisms a/w post-dysenteric form of reactive arthritis?
shigella flexneri
salmonella typhimurium
salmonella enteritidis
yersinia enterocolitica
campylobacter
organisms a/w post-sti form of reactive arthritis?
chlamydia trachomatis
mx of reactive arthritis?
symptomatic: analgesia, nsaids, (intra-articular) steroids
sulfasalazine, methotrexate if persistent disease
how long do symptoms last for in reactive arthritis?
rarely for longer than a year
what type of arthritis is seen in reactive arthritis?
assymmetrical oligoarthritis of lower limbs
time course of reactive arthritis?
usually develops within 4wks of infection with symptoms for 4-6 months
25% with recurrent episodes
10% with chronic disease
triad for disseminated gonococcal disease (DIFFERENT TO RA)
tenosynovitis
migratory polyarthritis
dermatitis
exposure to gi and gu infections a/w reactive arthritis - implicated bacteria?
chlamydia
salmonella
c. jejuni
cefalexin + nitrofurantoin coprescription increases risk of?
risk of nephrotoxicity
if cefalexin being given for recurrent UTIs then may consider switching to nitrofurantoin instead
when would you stop methotrexate?
signs of infection
neutropenic sepsis
