REACTIVE ARTHRITIS (TB) Flashcards
What is reactive arthritis?
An acute non-purulent arthritis that complicates an infection elsewhere in the body.
What infections commonly precede reactive arthritis?
Urinary tract infections, sexually transmitted diseases, or genitourinary infections.
What is the classic triad of reactive arthritis?
Arthritis, urethritis, and conjunctivitis.
What additional symptoms can be present in reactive arthritis besides the triad?
Mucocutaneous lesions, sometimes making it a pentad.
What genetic marker is commonly associated with reactive arthritis?
HLA-B27.
What enteric infections are associated with reactive arthritis?
Shigella, Salmonella, Yersinia, and Campylobacter species.
What is the most common genital infection associated with reactive arthritis?
Chlamydia trachomatis.
How does gender distribution differ in reactive arthritis?
Post-enteric infections affect men and women equally, while venereally acquired reactive arthritis occurs mainly in men.
What histologic findings are seen in reactive arthritis synovitis?
Similar to other spondyloarthropathies, with enthesitis, increased vascularity, and macrophage infiltration of fibrocartilage.
What inflammatory bowel disease-like changes are seen in reactive arthritis?
Colonic and ileal inflammation, especially in post-enteric reactive arthritis.
What skin lesion is associated with venereally acquired reactive arthritis?
Keratoderma blennorrhagica, histologically similar to pustular psoriasis.
What bacteria most commonly trigger reactive arthritis?
Salmonella (S. flexneri, S. sonnei), Shigella, Yersinia enterocolitica, Yersinia pseudotuberculosis, Campylobacter jejuni, and Chlamydia trachomatis.
How does HLA-B27 contribute to reactive arthritis?
It prolongs intracellular survival of Yersinia enterocolitica and Salmonella enteritidis, allowing infected leukocytes to traffic to joints.
What are the common constitutional symptoms of reactive arthritis?
Fatigue, malaise, fever, and weight loss.
How does reactive arthritis typically present in the joints?
Asymmetric arthritis, mainly affecting the lower extremities.
What is dactylitis?
A condition seen in reactive arthritis, also called ‘sausage digit,’ due to diffuse swelling of fingers or toes.
What are the common urogenital manifestations of reactive arthritis?
Urethritis and urogenital lesions throughout the disease course.
What is the most common ocular manifestation of reactive arthritis?
Uveitis.
What are the mucocutaneous lesions seen in reactive arthritis?
Oral ulcers, palm and sole lesions, and circinate balanitis (in males).
What cardiac complications can occur in reactive arthritis?
Aortic insufficiency.
What pulmonary complications are seen in reactive arthritis, especially in HIV patients?
Pleuropulmonary infiltrates.
What laboratory findings are seen in reactive arthritis?
Elevated ESR and acute-phase reactants, mild anemia, and nonspecific inflammatory cells in synovial fluid.
What is the most important test for diagnosing Chlamydia-induced reactive arthritis?
PCR for Chlamydial DNA in first-voided urine.
What are the characteristic radiologic findings in reactive arthritis?
Juxta-articular osteoporosis, periostitis with reactive bone formation, asymmetric sacroiliitis, and non-marginal ‘comma-shaped’ syndesmophytes.
