reactive arthritis

Question 1

what is reactive arthritis

Answer 1

infection induced systemic illness which is characterised by an inflammatory synovitis from which viable microorganisms cannot be cultured

Question 2

describe the aetiology of reactive arthritis

Answer 2

preceeding infection

HLA B27 +ve

young adults

equal sex distribution

Question 3

what are the most common preceeding infections of reative athritis

Answer 3

urogenital e.g. chalmydia

enterogenic e.g. salmonella or shigella

Question 4

describe the pathophysiology of reactive arthritis

Answer 4

response to an infection elsewhere

infection triggers an immune arthropathy

large joints e.g. knee becomes inflamed 1-3 weeks after infection

Question 5

descrive symptoms of reactive arthritis

Answer 5

1-4 weeks after infection

general - fever, fatigue, malaise

asymetrical monoarthritis

enthesitis

Question 6

signs of reactive arthritis

Answer 6

mucocutaneous lesions

ocular lesions

visceral manifestations - mild renal disease, carditis

reiters syndrome

Question 7

what is reiters syndrome

Answer 7

triad of urethritis, conjunctivitis/ uveitis/ iritis and athritis

Question 8

Ix in suspected reactive arthritis

Answer 8

bloods - inflammatory markers raised, FBC, U+E, LFTs, HLA B27

culture - blood, urine, stool

joint fluiud analysis to rult out infection

X ray of affected joint

Question 9

Mx of reactive arthritis

Answer 9

underlying infective cause and symptomatic relief

most self limiting - 90% resolve in 6 months

10% - chronic progressive and erosive - requires DMARDs