Reactive Arthritis Flashcards
What is reactive arthritis.
A sterile arthritis, typically affecting the lower limb 1-4 weeks after urethritis or dysentery.
What are the common causative organisms in urethritis. (2)
Chlamydia.
Ureaplasma.
What are the common causative organisms in dystentery. (4)
Campylobacter.
Salmonella.
Shigella.
Yersinia.
What is the aetiology of reactive arthritis.
It may be either chronic or relapsing.
What are the symptoms of reactive arthritis. (7)
Joint pain.
Iritis.
Keratoderma blenorrhagica (brown, raised plaques on soles and palms).
Circinate balanitis (painless penile ulceration secondary to Chlamydia).
Mouth ulcers.
Enthesitis.
Reiter’s syndrome may be present.
What is Reiter’s syndrome. (3)
A triad of:
Urethritis.
Arthritis.
Conjunctivitis.
What is seen on the blood test of a patient with reactive arthritis. (2)
Raised ESR.
Raised CRP.
What may be seen on XR of a patient with reactive arthritis. (2)
Ethesitis with periosteal reaction.
What is reactive arthritis associated with.
60-85% are HLA B27 positive.
What are the shared features of the spondyloarthropathies. (7)
Seronegative.
HLA B27 association.
Axial arthritis - pathology in the spine and sacroiliac joints.
Asymmetrical large joint oligoarthritis or monoarthritis.
Enthesitis - inflammation of the site of insertion of tendon or ligament into bone.
Dactylitis - inflammation of entire digit due to soft tissue oedema and tenosynovial and join inflammation.
Extra-articular manifestations - iritis, rashes, ulcers, aortic valve incompetence, IBD.
What are included in the family of spondyloarthropathies. (5)
Ankylosing spondylitis. Acute anterior uveitis. Reactive arthritis. Enteric arthropathy. Psoriatic arthritis.
What percentage of those with ankylosing spondylitis are positive for HLA B27.
88%.
What is of note of Behcet’s syndrome. (4)
Can present with uveitis, skin lesions and arthritis.
Not always associated with gross oral or genital ulcerations.
