Reactive arthritis is a type of arthritis that follows an infection. It may also cause inflammation of the eyes, skin, and urinary and genital systems.
Commonly Associated With
Reiter syndrome; Post-infectious arthritis; Arthritis Urethritica
The exact cause of reactive arthritis is unknown. However, it most often follows an infection, but the joint itself is not infected. Reactive arthritis occurs most often in men younger than age 4, although it does sometimes affect women. It may follow infection in the urethra after unprotected sex. The most common bacteria that cause such infections is called Chlamydia trachomatis. Reactive arthritis can also follow a gastrointestinal infection (such as food poisoning). In up to one-half of people thought to have reactive arthritis, there may be no infection. It is possible that such cases are a form of spondyloarthritis.
Certain genes may make you more likely to get this condition.
The disorder is rare in young children, but it may occur in teenagers. Reactive arthritis may occur in children ages 6 to 14 after Clostridium difficile gastrointestinal infections.
Urinary symptoms will appear within days or weeks of infection.
These symptoms may include:
- Burning when urinating
- Fluid leaking from the urethra (discharge)
- Problems starting or continuing a urine stream
- Needing to urinate more often than normal
- A low fever along with eye discharge, burning, or redness (conjunctivitis or “pink eye”) can develop over the next several weeks.
- Infections in the intestine may cause diarrhea and abdominal pain. Diarrhea may be watery or bloody.
- Joint pain and stiffness also begin during this time period. Arthritis may be mild or severe.
Arthritis symptoms may include:
- Heel pain or pain in the Achilles tendon
- Pain in the hip, knee, ankle, and low back
- Pain and swelling that affects one or more joints
- Symptoms may include skin sores on the palms and soles that look like psoriasis. There may also be small, painless ulcers in the mouth, tongue, and penis.
Exams & Tests
Your health care provider will diagnose the condition based on your symptoms. A physical exam may show signs of conjunctivitis or skin sores. All symptoms may not appear at the same time, so there may be a delay in getting a diagnosis.
You may have the following tests:
- HLA-B27 antigen
- Joint x-rays
- Blood tests to rule out other types of arthritis such as rheumatoid arthritis, gout, or systemic lupus erythematosus
- Erythrocyte sedimentation rate (ESR)
- Culture of stool if you have diarrhea
- Urine tests for bacterial DNA such as Chlamydia trachomatis
- Aspiration of a swollen joint
The goal of treatment is to relieve symptoms and treat the infection that is causing this condition.
Eye problems and skin sores do not need to be treated most of the time. They will go away on their own. If eye problems persist, you should be evaluated by a specialist in eye disease.
Your provider will prescribe antibiotics if you have an infection. Nonsteroidal anti-inflammatory drugs (NSAIDs) and pain relievers may help with joint pain. If a joint is very swollen for a long period of time, you may have corticosteroid medicine injected into the joint.
If arthritis continues in spite of NSAIDs, sulfasalazine or methotrexate may be helpful. Finally, people who do not respond to these medicines may need anti-TNF biologic agents such as etanercept (Enbrel) or adalimumab (Humira) to suppress the immune system.
Physical therapy can help ease the pain. It can also help you move better and maintain muscle strength.
Courtesy of MedlinePlus from the National Library of Medicine