Definition

What is reactive arthritis?

Reactive arthritis is joint pain and swelling triggered by an infection in another part of your body — most often your intestines, genitals or urinary tract.

Reactive arthritis usually targets your knees and the joints of your ankles and feet. Inflammation also can affect your eyes, skin and urethra.

Previously, reactive arthritis was sometimes called Reiter’s syndrome, which was characterized by eye, urethra and joint inflammation.

How common is reactive arthritis?

Reactive arthritis isn’t common. For most people, signs and symptoms come and go, eventually disappearing within 12 months. Reactive arthritis can occur at any age, but it most commonly affects young adults aged 20-40. Men are generally affected more than woman – particularly in cases linked to STIs, which are estimated to be about 10 times more common in men.

People who have a certain gene called HLA-B27 are about thought to be around 50 times more likely to develop reactive arthritis than those who don’t have this gene. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of reactive arthritis?

The first symptoms of reactive arthritis are painful urination and a discharge from the penis if there is inflammation of the urethra. Diarrhea may occur if the intestines are affected. This is then followed by arthritis four to 28 days later that usually affects the fingers, toes, ankles, hips, and knee joints. Typically, only one or a few of these joints may be affected at one time. Other symptoms include:

  • Mouth ulcers
  • Inflammation of the eye
  • Keratoderma blennorrhagica (patches of scaly skin on the palms, soles, trunk, or scalp)
  • Back pain from sacroiliac (SI) joint involvement
  • Pain from inflammation of the ligaments and tendons at the sites of their insertion into the bone (enthesitis)

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you develop joint pain within a month of having diarrhea or a genital infection, contact your doctor.

Causes

What causes reactive arthritis?

Reactive arthritis develops in reaction to an infection in your body, often in your intestines, genitals or urinary tract. You might not be aware of the triggering infection if it causes mild symptoms or none at all.

Numerous bacteria can cause reactive arthritis. Some are transmitted sexually, and others are foodborne. The most common ones include:

  • Chlamydia
  • Salmonella
  • Shigella
  • Yersinia
  • Campylobacter
  • Clostridium difficile

Reactive arthritis isn’t contagious. However, the bacteria that cause it can be transmitted sexually or in contaminated food. Only a few of the people who are exposed to these bacteria develop reactive arthritis.

Risk factors

What increases my risk for reactive arthritis?

There are many risk factors for reactive arthritis, such as:

  • Reactive arthritis occurs most frequently in adults between the ages of 20 and 40.
  • Women and men are equally likely to develop reactive arthritis in response to foodborne infections. However, men are more likely than are women to develop reactive arthritis in response to sexually transmitted bacteria.
  • Hereditary factors. A specific genetic marker has been linked to reactive arthritis. But many people who have this marker never develop the condition.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is reactive arthritis diagnosed?

Diagnosis of reactive arthritis can be complicated by the fact that symptoms often occur several weeks apart. A doctor may diagnose reactive arthritis when the patient’s arthritis occurs together with or shortly following inflammation of the eye and the urinary tract and lasts a month or longer.

There is no specific test for diagnosing reactive arthritis, but the doctor may check the urethral discharge for sexually transmitted diseases. Stool samples may also be tested for signs of infection. Blood tests of reactive arthritis patients are typically positive for the HLA-B27 genetic marker, with an elevated white blood cell count and an increased erythrocyte sedimentation rate (ESR) — both signs of inflammation. The patient may also be mildly anemic (having too few red blood cells in the bloodstream).

X-rays of the joints outside the back do not usually reveal any abnormalities unless the patient has had recurrent episodes of the disease. On an X-ray, joints that have been repeatedly inflamed may show areas of bone loss, signs of osteoporosis, or bony spurs. Joints in the back and pelvis (sacroiliac joints) may show abnormalities and damage from reactive arthritis.

How is reactive arthritis treated?

Bacterial infections, such as chlamydia, will need to be treated with antibiotics. Joint inflammation from reactive arthritis is usually treated with nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen, aspirin, or ibuprofen. Skin eruptions and eye inflammation can be treated with steroids.

Those with chronic disease may be prescribed other medications, including methotrexate. Patients with chronic arthritis also may be referred to a physical therapist and may be advised to exercise regularly.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage reactive arthritis?

The following lifestyles and home remedies might help you prevent reactive arthritis:

Genetic factors appear to play a role in whether you’re likely to develop reactive arthritis. Though you can’t change your genetic makeup, you can reduce your exposure to the bacteria that may lead to reactive arthritis.

Make sure your food is stored at proper temperatures and is cooked properly to help you avoid the many foodborne bacteria that can cause reactive arthritis, including salmonella, shigella, yersinia and campylobacter. Some sexually transmitted infections can trigger reactive arthritis. Using condoms might lower your risk.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 11, 2017 | Last Modified: December 11, 2017

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