Reactive Arthritis Flashcards
What is reactive arthritis?
STERILE arthritis occurring after an extra-articular infection (GI or urogenital).
What is Reiters syndrome?
Reactive arthritis
Urethritis
Conjunctivitis
List 4 GI infections that predispose to reactive arthritis
Salmonella
Shigella
Yersinia
Campylobacter
What urogenital infection predisposes to reactive arthritis?
Chlamydia trachomatis
Describe the pathophysiology of reactive arthritis
Initial activation of the immune system by a microbial antigen is followed by an AI reaction that involves the skin, eyes + joints
70-80% of patients have HLA-B27 allele
Describe the epidemiology of reactive arthritis
20 x more common in MALES
Age of onset: 20-40 yrs
Seen in 2% of patients with non-specific urethritis
List 5 symptoms of reactive arthritis
Burning or stinging when passing urine (due to urethritis)
Arthritis
Low back pain (due to sacroiliitis)
Painful heels (due to enthesitis and plantar fasciitis)
Conjunctivitis
When do symptoms start in reactive arthritis?
Symptoms can develop 3-30 days after infection
What arthritic signs are seen in reactive arthritis?
Asymmetrical oligoarthritis
Often affects the lower extremities
Sausage-shaped digits
What 3 characteristic signs may be seen in reactive arthritis?
Signs of Conjunctivitis: Anterior uveitis; painful red eye
Oral Ulceration
Circinate Balanitis: Scaling red patches on the glans
What dermatological sign may be seen in reactive arthritis? Describe this
Keratoderma Blenorrhagica: Brownish-red macules Vesicopustules Yellowish-brown scales Found on SOLES + PALMS
What less specific signs are seen in reactive arthritis?
Nail dystrophy
Hyperkeratosis
Onycholysis
What bloods should be taken in reactive arthritis?
High ESR + CRP
HLA-B27 testing
Why may stool or urethral swabs and cultures be negative in reactive arthritis?
Arthritis occurs post-infection
Why would you take a urine sample in reactive arthritis?
Screen for Chlamydia trachomatis
