reactive arthritis

Reactive Arthritis: A Temporary Form of Inflammatory Arthritis

Reactive arthritis, also known as Reiter's syndrome, is a rare and temporary form of inflammatory arthritis that occurs due to an infection in another part of the body. This type of arthritis is not contagious, but the underlying infection could be.

Causes and Triggers

Reactive arthritis can be triggered by various bacterial infections, including Chlamydia trachomatis, salmonella, and others. The condition may also be caused by other types of infections, such as urinary tract issues.

Symptoms

The first signs of reactive arthritis often include:

• Painful and swollen joints, usually in the ankles or knees
• Sausage-like swelling of fingers or toes

Other symptoms may include pain, stiffness, and swelling in the joints and tendons. In some cases, reactive arthritis can also affect the eyes, urethra (the tube that carries urine from the bladder to the penis), vagina, and other parts of the body.

Characteristics

Reactive arthritis is a self-limited condition, meaning it typically resolves on its own within six months of onset. The disorder predominantly affects males aged 20-40 and individuals with HLA-B27 antigen are estimated to have a 50% increased risk.

Key Points:

• Reactive arthritis is an inflammatory type of arthritis that occurs due to an infection in another part of the body [1].
• It can be triggered by various bacterial infections, including Chlamydia trachomatis and salmonella [5].
• The first signs of reactive arthritis often include painful and swollen joints, usually in the ankles or knees [6].
• Other symptoms may include pain, stiffness, and swelling in the joints and tendons [8].
• Reactive arthritis is a self-limited condition that typically resolves on its own within six months of onset [10].

References:

[1] - Context result 2 [5] - Context result 5 [6] - Context result 6 [8] - Context result 8 [10] - Context result 10

Reactive arthritis, also known as Reiter's syndrome, is a rare form of inflammatory arthritis that occurs in response to a bacterial infection. The symptoms of reactive arthritis can vary from person to person, but they often include:

• Pain and swelling in joints: Pain, stiffness, and swelling in the joints and tendons are common symptoms of reactive arthritis. This can occur in any joint, but it's most commonly seen in the knees, feet, toes, hips, and ankles [5][10].
• Eye inflammation (conjunctivitis): Many people with reactive arthritis develop eye inflammation, which can cause redness, pain, and discharge from the eyes [2][13].
• Urinary problems: Increased frequency and discomfort during urination may occur, as can inflammation of the prostate gland or cervix [2].
• Pain during urination: Pain when peeing is a common symptom of reactive arthritis [13].
• Frequent urination: Need to urinate more frequently is another symptom that people with reactive arthritis often experience [7].
• Rash on palms or soles: Some people may develop a rash on the palms or soles of their feet [8].
• Lower back pain: Persistent lower back pain, especially at night or in the morning, can be a symptom of reactive arthritis [8].

It's worth noting that these symptoms can be very mild and come and go over several weeks to months. In some cases, people may experience recurring symptoms even after treatment [11].

Reactive arthritis, also known as Reiter's Syndrome, is a type of arthritis that occurs due to an infection [3]. While there is no single test that can confirm the diagnosis of reactive arthritis, several diagnostic tests and examinations may be conducted by medical professionals to confirm an infection and rule out other conditions.

Diagnostic Tests:

• Blood tests: These may include rheumatoid factor (RF) testing, which detects antibodies against gamma globulin [10]. However, this test is often positive in people with rheumatoid arthritis and negative in those with psoriatic arthritis.
• Erythrocyte sedimentation rate (ESR): This test measures the level of inflammation in the body [11].
• Other blood tests may be done to rule out other conditions such as rheumatoid arthritis and lupus.

Physical Examination:

• A physical examination is conducted by a medical professional, which includes checking for swelling, warmth, and tenderness in joints, as well as testing range of motion in the spine and other areas [2].
• The doctor may also ask about your medical history, symptoms, and current medical problems [13].

Imaging Studies:

• Ultrasound scans and X-rays may be ordered to rule out other conditions or to confirm joint inflammation.

It's essential to note that there is no specific test or marker that can conclusively diagnose reactive arthritis. A high index of suspicion is required by medical professionals, and a combination of clinical findings, laboratory tests, and imaging studies are used to make the diagnosis [5].

References: [2] - During the physical exam, your doctor is likely to check your joints for swelling, warmth and tenderness, and test range of motion in your spine and ... [3] Reactive arthritis is a type of arthritis that occurs due to an infection. Arthritis is when joints become inflamed and painful. Reactive arthritis is not contagious. It's also known as Reiter's Syndrome. [5] September 28, 2024 - The diagnosis of reactive arthritis (ReA) is clinical, based on the history and physical examination findings. A high index of suspicion is required. No laboratory study or imaging finding is diagnostic of ReA. [10] June 12, 2022 - Rheumatoid factor (RF) – Detects and measures the level of an antibody that acts against the blood component gamma globulin. [11] Some blood tests may be done to rule out other conditions, such as rheumatoid arthritis and lupus. Other tests may include: Erythrocyte sedimentation rate (ESR ... [13] The patient may be referred to a rheumatologist, depending on the severity of symptoms. Some of the methods used to diagnose reactive arthritis include · Physical Examination. The doctor will ask about your medical history, symptoms and current medical problems.

Treatment Options for Reactive Arthritis

Reactive arthritis, an inflammatory type of arthritis, can be treated with various medications to manage symptoms and prevent chronic complications. The goal of treatment is to relieve pain, reduce inflammation, and clear any underlying infection.

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These are the initial treatment of choice in the acute phase, including ibuprofen, naproxen, diclofenac, indomethacin, celecoxib, amongst others [8]. NSAIDs can help to reduce pain and inflammation.
• Disease-Modifying Anti-Rheumatic Drugs (DMARDs): These medicines suppress the immune system on a broad level, helping to block inflammation in the joints. DMARDs may be prescribed for people with chronic reactive arthritis or those who experience severe symptoms [4].
• Antibiotics: If the reactive arthritis is triggered by a bacterial infection, antibiotics such as doxycycline or its analogs may be prescribed to treat the underlying infection and shorten the course of the arthritis [13].
• Steroids: Steroids can be used to treat skin eruptions and eye inflammation associated with reactive arthritis.
• Biologics: In severe cases, biologic medications such as tumor necrosis factor (TNF)-blockers may be prescribed off-label for reactive arthritis treatment.

It's essential to note that while these treatments can help manage symptoms, there is no cure for reactive arthritis. Treatment aims to relieve symptoms and prevent chronic complications. The choice of medication depends on the severity of the condition, age, general health, and individual response to treatment [6].

References:

[4] - Disease-modifying anti-rheumatic drugs (DMARDs) may be prescribed for people with chronic reactive arthritis or those who experience severe symptoms. [8] - Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are the initial treatment of choice in the acute phase, including ibuprofen, naproxen, diclofenac, indomethacin, celecoxib, amongst others. [13] - Antibiotics such as doxycycline or its analogs may be prescribed to treat the underlying infection and shorten the course of the arthritis.

Reactive arthritis, also known as Reiter syndrome, can be challenging to diagnose due to its similarity in symptoms with other conditions. The differential diagnosis for reactive arthritis includes:

• Ankylosing spondylitis: A type of arthritis that primarily affects the spine and large joints, often accompanied by inflammation in other parts of the body [9].
• Psoriatic arthritis: A condition characterized by joint pain and swelling, often associated with psoriasis, a skin condition [2].
• Inflammatory bowel disease-associated spondyloarthropathy: A type of arthritis that occurs in people with inflammatory bowel diseases such as Crohn's disease or ulcerative colitis [9].
• Undifferentiated spondyloarthritis: A term used to describe a group of conditions characterized by inflammation in the spine and other joints, without meeting the specific criteria for ankylosing spondylitis or psoriatic arthritis [9].
• Septic arthritis: A condition caused by a bacterial infection that leads to joint pain and swelling, which can mimic the symptoms of reactive arthritis [1].
• Pyogenic arthritis: A type of septic arthritis characterized by pus formation in the joints, often accompanied by fever and other systemic symptoms [1].

It's essential for healthcare providers to consider these differential diagnoses when evaluating patients with suspected reactive arthritis. This allows for a comprehensive assessment and accurate diagnosis, which is crucial for effective treatment and management.

References: [1] - Septic arthritis must be ruled out if suspected before a diagnosis of ReA is made [1]. [2] - Patients with psoriasis have fewer symptoms with reactive arthritis, share an asymmetric pattern, sausage digits and distal interphalangeal joint involvement [2]. [9] - This group of disorders includes reactive arthritis, ankylosing spondylitis, psoriatic arthritis, undifferentiated spondyloarthritis and spondyloarthropathy associated with inflammatory bowel disease [9].