Rheumatological disease in a child: Reactive arthritis Flashcards
Define reactive arthritis.
Autoimmune condition that develops to an infection in other part of the body. It is a term reserved for a sterile inflammatory arthritis occurring in after an infection in the body. One of the most common childhood rheumatic diseases.
Explain the aetiology/risk factors of reactive arthritis.
The enteric bacteria (Salmonella, Shigella, Campylobacter and Yersinia) are often the cause in children.
Viral infections, sexually transmitted infections in adolescents (chlamydia, gonococcus), Mycoplasma and Borrelia burgdorferi (Lyme disease) are other causes.
Summarise the epidemiology of reactive arthritis.
Rheumatic fever and post-streptococcal reactive arthritis are rare in high-income countries but are frequent in many low and middle-income countries.
What are signs and symptoms of reactive arthritis?
It is characterised by transient joint swelling (usually < 6 weeks) often of the ankles or knees.
Low grade fever.
What are appropriate investigations for reactive arthritis?
Stool and urine culture
Serology for arthitogenic bacteria
PCR to detect bacterial DNA from synovial material
Urethral swabs
X-ray (will be normal)
What is the management for reactive arthritis?
NSAIDS
What are complications associated with reactive arthritis?
Recurrent arthritis
Chronic arthritis
Sacroiliitis
Ankylosing spondylitis
What is the prognosis of reactive arthritis?
Varies, most of them remit after one episode but some cases up to 30% may have recurrent or chronic involvement and even may have identifiable spondyloarthropathy later.
