Reactive arthritis Flashcards
What is reactive arthritis?
Reactive arthritis is a form of synovitis that occurs in response to an infection, most commonly affecting a single joint, usually the knee.
Synovitis refers to inflammation of the synovial joints.
What is the most common joint affected by reactive arthritis?
The knee is the most commonly affected joint in reactive arthritis.
How does reactive arthritis differ from septic arthritis?
In reactive arthritis, the infection triggers inflammation in the joint, but there is no infection inside the joint. In septic arthritis, the infection is present inside the joint.
What are the most common triggers of reactive arthritis?
The most common triggers are:
* Gastroenteritis (e.g., caused by Salmonella or Shigella)
* Sexually transmitted infections, particularly Chlamydia.
What is the link between reactive arthritis and HLA B27?
Reactive arthritis is a seronegative spondyloarthropathy associated with the HLA B27 gene, which predisposes individuals to the condition.
Is reactive arthritis more common in any specific population?
It is more common in patients with HIV, and HIV should be excluded in patients with reactive arthritis.
What are some common associations with reactive arthritis?
Common associations include:
* Bilateral conjunctivitis (non-infective)
* Anterior uveitis
* Urethritis (non-gonococcal)
* Circinate balanitis (dermatitis on the head of the penis)
What mnemonic helps remember the classic triad of symptoms in reactive arthritis?
The mnemonic ‘can’t see, pee, or climb a tree’ helps remember the classic triad of conjunctivitis, urethritis, and arthritis.
How should a patient with an acute swollen, painful joint be managed?
The patient should be treated according to the local hot joint policy, and septic arthritis must be excluded. Antibiotics may be given until septic arthritis is ruled out.
What diagnostic procedure is required to exclude septic arthritis in reactive arthritis?
Joint aspiration is required to send synovial fluid for microscopy, culture and sensitivity testing for infection, and crystal examination for gout and pseudogout.
What is the treatment for reactive arthritis after septic arthritis is excluded?
Treatment includes:
* Treatment of the triggering infection (e.g., Chlamydia)
* NSAIDs for symptom relief
* Steroid injections into affected joints
* Systemic steroids may be needed for multiple joint involvement.
What is the prognosis for reactive arthritis?
Most cases resolve within 6 months and do not recur. Recurrent cases may require DMARDs or anti-TNF medications.
