Reactive arthritis

Question 1

Reactive arthritis

Answer 1

Where synovitis occurs in the joints as a reaction to a recent infective trigger

Typically causes acute monoarthritis

HLA-B27 associated seronegative spondyloarthropathy

Question 2

Epidemiology

Answer 2

Post STI form much more common in men

Post-dysenteric form equal in sex incidence

Question 3

Post-dysenteric form

Answer 3

SHigella flexneri

Salmonella typhimurium

Salmonella enteritidis

Yersinia enterocolitica

Campylobacter

Question 4

Post STI form

Answer 4

Chlamydia trachomatis

Question 5

Associations

Answer 5

Bilateral conjunctivitis

Anterior uveitis

Circinate balanitis (dermatitis of the head of the penis)

‘Can’t see, pee or climb a tree’

Question 6

Hot joint management

Answer 6

Give antibiotics until possibility of septic arthritis is excluded

Aspirate joint and send a sample for gram staining, culture and sensitivity testing to exclude septic arthritis

Question 7

Management of reactive arthritis

Answer 7

NSAIDs

Steroid injection into affected joints

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

Symptoms rarely last more than 12 months