Reactive Arthritis

Question 1

What is reactive arthritis?

Answer 1

Synovitis occurs in the joints as a reaction to a recent infective trigger

Typically it causes an acute monoarthritis

Question 2

What joint is most commonly affected in reactive arthritis?

Answer 2

Knee

Question 3

What are the common triggers of reactive arthritis?

Answer 3

Gastroenteritis

Sexually transmitted infection - Chlamydia
Gonorrhoea commonly causes a gonococcal septic arthritis

Question 4

What conditions are related to HLA B27?

Answer 4

P - Psoriasis
A - Ank Spond
I - IBD
R - Reactive Arthritis`

Question 5

Can’t See, Pee, Climb a tree

Answer 5

Bilateral conjunctivitis (non-infective)
Anterior uveitis

Circinate balanitis is dermatitis of the head of the penis

Question 6

What is the management of reactive arthritis?

Answer 6

Giving antibiotics until the possibility of septic arthritis is excluded

Aspirate - gram staining, culture and sensitivity to exclude SA
Can also be sent for crystal examination

Question 7

Presentation of reactive arthritis

Answer 7

Warm, swollen, painful joint

Question 8

Management of reactive arthritis when septic arthritis is excluded

Answer 8

NSAIDs

Steroid injections into the affected joints

Systemic steroids may be required, particularly where multiple joints are affected

Most resolve within 6 months and don’t recur. Recurrent cases may require DMARDs or anti-TNF medications