Reactive Arthritis Flashcards
What is spondyloarthropathies?
Group of inflammatory arthritides that share genetic HLA B27 and clinical features
What is seronegative?
Typically blood testing for Rf and ANA is negative
What is enthesitis?
Inflammation where ligaments and tendons insert into bones
What does the PEAR acronym stand for?
P: Psoriatic arthritis
E: Enteropathic arthritis
A: Ankylosing spondylitis
R: Reactive Arthritis
What is reactive arthritis also known as?
Reiter’s syndrome
What are the symptoms of Reactive arthritis?
- Arthritis
- Conjunctivitis
- Non-gonococcal urethritis
*all following bouts of bloody dysentery or genitourinary infection - > 75% are HLA B27 positive
*”Cant pee, can’t see, can’t climb a tree”
What is reactive arthritis?
- Secondary immune reaction (autoimmune response) to a primary infection (dysentery or STI) in another part of the body *usually 1-4 weeks after
What are the most common infections to cause reactive arthritis?
- Chlamydia
- Yersinia
- Campylobacter
- Shigella
- Salmonella
- Gonorrhea
What are the first manifestations of reactive arthritis in males?
- Mucopurulent discharge
- Dysuria
- Prostatitis
- Epididymitis
What are the first manifestations of reactive arthritis in females?
- Dysuria
- Vaginal discharge
- Purulent Cervicitis
When does conjunctivitis occur in reactive arthritis?
- Follows urethritis by several days
- Sx often mild and transient
- Acute anterior uveitis possible (severe eye pain)
What symptoms of reactive arthritis usually occur last?
- Articular symptoms
*additive (one joint, then another joint)
*oligoarticular
*LE most common (Knee and ankle)
*Sacroiliitis or ankylosing spondylitis present in 20%
*sterile oligoarthritis (joint is not septic)
*Sausage finger and toes
What type of mucocutaneous lesion may be present with reactive arthritis?
- Circinate balanitis (inflammation at the end of the penis)
- Stomatitis (painful sores in the mouth)
- Keraderma blennorrhagicum (spots at the bottom of the feet)
What are the neurological complications of reactive arthritis?
- Peripheral neuropathies
- Encephalopathy
- Transverse myelitis (inflammatory process of the gray and white matter)
What lab findings are associated with reactive arthritis?
- Anemia
- Leukocytosis (10,000 to 20,000 wbc)
- Increased IgG (protects against bacterial and viral infections)
- Acute phase reactants
*elevated ESR
*Elevated CRP - HLA B27 positive 80% white patients, 50-60% black patients
- Synovial fluid
*highly inflammatory - Sterile cultures
*negative gram stain and culture - X-ray
*reveals periostitis
