Reactive Arthritis Flashcards
Reactive arthritis (now encompasses Reiter’s syndrome which is not really used anymore. Reiter’s is now throught to be Post-STI reactive arthritis or sexually aquired reactive arthritis(SARA).).
What is the classic triad of Post-STI Reactive arthritis/SARA/Reiter’s syndrome and how do you remember it?
Urethritis, conjunctivitis and arthritis
“Can’t see, pee or climb a tree”
What are the 2 types of reactive arthritis?
Post-dysenteric reactive arthritis
Post-STI reactive arthritis
What is the definition of reactive arthritis?
An arthritis that develops following an infection where the organism cannot be recovered from the joint.
Is reactive arthritis an HLA-B27 positive or negative spondyloarthropathy?
HLA-B27 negative spondyloarthropathy
What are the typical features of reactive arthritis?
- Typically develops within 4 weeks of initial infection - symptoms generally last around 4-6 months
- Arthritis is typically an asymmetrical oligoarthritis of lower limbs
- Dactylitis
- Symptoms of urethritis
- Eye: conjunctivitis (seen in 50%), anterior uveitis
-
Skin:
- Circinate balanitis (painless vesicles on the coronal margin of the prepuce)
- Keratoderma blenorrhagica (waxy yellow/brown papules on palms and soles)
What is this?
Keratoderma blenorrhagica
What is this?
Circinate Balanitis
What is this?
Circinate Balanitis
Which is more common in men?
Post-STI reactive arthritis
10:1
What are the commonly associated causes of post-dysenteric reactive arthritis?
- Shigella flexneri
- Salmonella typhimurium
- Salmonella enteritidis
- Yersinia enterocolitica
- Campylobacter
What is the common cause of Post-STI reactive arthritis?
Chlamydia trachomatis
What is the management of reactive arthritis?
- Symptomatic: analgesia, NSAIDS, intra-articular steroids
- Sulfasalazine and methotrexate are sometimes used for persistent disease
- Symptoms rarely last more than 12 months
What is the prognosis of reactive arthritis?
25% of patients have recurrent episodes
10% develop chronic disease
