Reactive Arthritis Flashcards
reactive arthritis is the most common type of inflammatory ______ ______ in young men aged 40 and younger
asymmetric oligoarthritis
what does reactive arthritis usually follow? (2)
nongonococcal GU infections (STI)
GI infection (gastroenteritis)
what subclass does reactive arthritis fall into?
seronegative spondyloarthropathies
what 3 organisms usually cause gastroenteritis, which leads to reactive arthritis?
shigella
salmonella
campylobacter
what organism usually causes an STI, which leads to reactive arthritis?
chlamydial trachomatis
in which gender is post chlamydial reactive arthritis most common in?
males
what is the classic triad of symptoms in reactive arthritis?
“can’t pee, can’t see, can’t climb a tree”
urethritis
conjunctivitis
arthritis
which 2 weight bearing joints are most commonly affected?
knee
ankle
when does joint pain typically occur in reactive arthritis? (2)
night
early morning
what are 2 common features in reactive arthritis?
low back pain
tendinitis
what will be noticed on the skin or mucosal surfaces in reactive arthritis?
scaly rash on palms and soles
stomatitis (inflamed mouth/lips)
what will be present in labs of reactive arthritis? (2)
elevated ESR/CRP
+ HLA-B27
what is the most common cause of reactive arthritis and accounts for most cases?
chlamydia trachomatis
why would synovial fluid show inflammation with a negative gram stain and negative culture?
considered a sterile (aseptic) arthritis
what is the treatment for reactive arthritis if caused by chlamydia? (2)
doxycycline (azithromycin if pregnant)
indomethacin (NSAID)
what should be added to the treatment for reactive arthritis in patients with large joint effusions?
intra-articular steroids
what is the 2nd line treatment for reactive arthritis?
DMARDs (sulfasalazine or methotrexate)
which patients are at high risk for recurrence of reactive arthritis?
+ HLA-B27
what do symptoms for over 6 months indicate?
chronic arthritic disease
what is the most common chronic joint involvement associated with reactive arthritis?
sacroiliitis
what should be done to rule out septic arthritis?
synovial fluid aspiration + culture
