Reactive Arthritis

Question 1

Reactive Arthritis – Reiter’s syndrome

Answer 1

Symptom complex that includes urethritis, conjunctivitis and mucocutaneous lesions.
Exact etiology is unknown.-Believed STDs are a big factor
Genetic predisposition ??? HLA B27 at high risk of developing
Chlamydia trachomatis – in sexually transmitted reactive arthritis
GI infections – Shigella, Salmonella, Campylobacter, Yersinia

Question 2

Reactive Arthritis- Clinical Manifestations

Answer 2

Urethritis – 1 to 2 weeks after sexual contact or GI infection

Cervicitis- women

Low grade fever, conjunctivitis, arthritis

Asymmetric arthritis, involving large joints of LE and toes

Lower back pain with severe disease

Lesions- on mucous membranes

Achilles tendinitis

Plantar fasciitis

ESR may be elevated

Question 3

Treatment

Answer 3

Doxycycline (both for patient and sexual partner)
Ophthalmic corticosteroids- uveitis-middle layer of the eyes. No Tx for conjuctivitis
NSAIDS
DMARDS –e.g methotrexate , sulfasalazine
Physical therapy
Complete remission in most
20% may develop chronic arthritis