Reactive arthritis

Question 1

What is reactive arthritis?

Answer 1

Sterile synovitis (arthritis) which occurs as an autoimmune response following an infection elsewhere in the body; distal mucosal infection.

Question 2

What is presentation of reactive arthritis?

Answer 2

More common in men and occurs days to weeks post infection

• Acute, asymmetrical lower limb arthritis 
• Iritis and conjunctivitis and uveitis 
• Mouth ulcers 
• Plantar fasciitis, sacroilitis, spondylitis, anterior uveitis 
• Dactylitis, enthesitis, bursitis. 
• Keratoderma blenorrhagica 
	• Raised brown plaques on soles/palms  Associated with HLA B27

Question 3

What organisms can cause reactive arthritis?

Answer 3

• Salmonella
  
  • Shigella
  • Yersinia
  • Chlamydia

Question 4

What Ix in reactive arthritis?

Answer 4

Bloods: ESR and CRP elevated

RF and ANA -ve

NAAT tests for organisms

X-ray and US

Question 5

What is Rx of reactive arthritis?

Answer 5

treatment doesn’t alter course of disease
NSAIDs
Intra-articular steroids

sulfasalazine and methotrexate are sometimes used for persistent disease

Question 6

Complications of reactive arthritis?

Answer 6

• Cardiac
  ○ Aortic regurgitation
  ○ Aortitis
  Amyloidosis