Reactive Arthritis ( Reiter's Syndrome) - finished

Question 1

Reiters Syndrome/ Reactive Arthritis Definition:

Answer 1

Is an arthritis associated with:

1. Non-bacterial urethritis
2. Conjunctivitis
3. Mucocutaneous lesion

• Classified as seronegative spondylaropathy

Question 2

Aetiology/Epidemiology of ReA

Answer 2

Two forms:

- Sexually transmitted (Mainly males, 20-40 yoa, with chlamydia)
- Dysenteric: most often follows enteric bacterial infection i.e. salmonella. (Mainly women + children and elderly

Question 3

Pathology of ReA

Answer 3

*Changes = AS, but emphasis is on lower limb (early), IIJ’s (later), vertebral joints (later) +/- mucocutaneous lesions

Question 4

Clinical features of ReA

Answer 4

• Classic triad (30% of patients)
  - Non-infectious urethritis
  - Arthritis
  - Conjunctivitis

Extra Articular:

• Conjunctivitis
• Urethritis
• Balanitis
• Cervacitis
• Ulceration of the mouth
• Bowel infection

Question 5

Acute Phase of ReA

Answer 5

3-4 months

• Asymmetrical inflammation of the lower limb (knee and ankle)
• Joint may be: Acutely painful, hot, swollen tense effusion
• Ensethopathy (achilles and plantar fascia)
• backache
• Milda extra-articular manifestations

Question 6

Chronic phase of ReA

Answer 6

(50% of pts)

• Observe typical manifestations of spondylarthropahy
• 50% patients may have mild, recurrent poly arthritis
• 50% develop sacroilitis, spondylitis

Question 7

Radiology clinical features of Reiters

Answer 7

• Initially normal
• Erosive arthritis (after many months)
• Sacroiliac and vertebral changes are (single based and spondylitis
• Paraspinal ossification