Reactive Arthritis Flashcards

1
Q

reactive arthritis is the most common type of inflammatory ______ ______ in young men aged 40 and younger

A

asymmetric oligoarthritis

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2
Q

what does reactive arthritis usually follow? (2)

A

nongonococcal GU infections (STI)
GI infection (gastroenteritis)

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3
Q

what subclass does reactive arthritis fall into?

A

seronegative spondyloarthropathies

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4
Q

what 3 organisms usually cause gastroenteritis, which leads to reactive arthritis?

A

shigella
salmonella
campylobacter

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5
Q

what organism usually causes an STI, which leads to reactive arthritis?

A

chlamydial trachomatis

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6
Q

in which gender is post chlamydial reactive arthritis most common in?

A

males

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7
Q

what is the classic triad of symptoms in reactive arthritis?

A

“can’t pee, can’t see, can’t climb a tree”

urethritis
conjunctivitis
arthritis

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8
Q

which 2 weight bearing joints are most commonly affected?

A

knee
ankle

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9
Q

when does joint pain typically occur in reactive arthritis? (2)

A

night
early morning

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10
Q

what are 2 common features in reactive arthritis?

A

low back pain
tendinitis

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11
Q

what will be noticed on the skin or mucosal surfaces in reactive arthritis?

A

scaly rash on palms and soles
stomatitis (inflamed mouth/lips)

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12
Q

what will be present in labs of reactive arthritis? (2)

A

elevated ESR/CRP
+ HLA-B27

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13
Q

what is the most common cause of reactive arthritis and accounts for most cases?

A

chlamydia trachomatis

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14
Q

why would synovial fluid show inflammation with a negative gram stain and negative culture?

A

considered a sterile (aseptic) arthritis

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15
Q

what is the treatment for reactive arthritis if caused by chlamydia? (2)

A

doxycycline (azithromycin if pregnant)
indomethacin (NSAID)

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16
Q

what should be added to the treatment for reactive arthritis in patients with large joint effusions?

A

intra-articular steroids

17
Q

what is the 2nd line treatment for reactive arthritis?

A

DMARDs (sulfasalazine or methotrexate)

18
Q

which patients are at high risk for recurrence of reactive arthritis?

A

+ HLA-B27

19
Q

what do symptoms for over 6 months indicate?

A

chronic arthritic disease

20
Q

what is the most common chronic joint involvement associated with reactive arthritis?

A

sacroiliitis

21
Q

what should be done to rule out septic arthritis?

A

synovial fluid aspiration + culture