Reactive arthritis
Reactive arthritis
Reactive arthritis is one of the HLA-B27 associated seronegative spondyloarthropathies. It encompasses what was formerly called Reiter's syndrome*, a term which described a classic triad of urethritis, conjunctivitis and arthritis following a dysenteric illness during the Second World War. Later studies identified patients who developed symptoms following a sexually transmitted infection (post-STI, now sometimes referred to as sexually acquired reactive arthritis, SARA).Reactive arthritis is defined as an arthritis that develops following an infection where the organism cannot be recovered from the joint.
Epidemiology
- post-STI form much more common in men (e.g. 10:1)
- post-dysenteric form equal sex incidence
The table below shows the organisms that are most commonly associated with reactive arthritis:
| Post-dysenteric form | Post-STI form |
|---|---|
| Shigella flexneri Salmonella typhimurium Salmonella enteritidis Yersinia enterocolitica Campylobacter | Chlamydia trachomatis |
Management
- symptomatic: analgesia, NSAIDS, intra-articular steroids
- sulfasalazine and methotrexate are sometimes used for persistent disease
- symptoms rarely last more than 12 months
*as Reiter was a member of the Nazi party the term is no longer used
+PassMedicine Notes
Reactive arthritis is one of the HLA-B27 associated seronegative spondyloarthropathies. It encompasses what was formerly called Reiter's syndrome*, a term which described a classic triad of urethritis, conjunctivitis and arthritis following a dysenteric illness during the Second World War. Later studies identified patients who developed symptoms following a sexually transmitted infection (post-STI, now sometimes referred to as sexually acquired reactive arthritis, SARA).
Reactive arthritis is defined as an arthritis that develops following an infection where the organism cannot be recovered from the joint.
'Can't see, pee or climb a tree'
Epidemiology- post-STI form much more common in men (e.g. 10:1)
- post-dysenteric form equal sex incidence
The table below shows the organisms that are most commonly associated with reactive arthritis:
Post-dysenteric form _ Post-STI form| Shigella flexneri Salmonella typhimurium Salmonella enteritidis Yersinia enterocolitica Campylobacter _ Chlamydia trachomatis| Management- symptomatic: analgesia, NSAIDS, intra-articular steroids
- sulfasalazine and methotrexate are sometimes used for persistent disease
- symptoms rarely last more than 12 months
*as Reiter was a member of the Nazi party the term is no longer used
