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Did you know that reactive arthritis is closely related to these common bacteria?
Reactive arthritis, formerly known as Reiter's syndrome, is a type of inflammatory arthritis that is triggered by an infection elsewhere in the body. The disease is triggered when there is contact with bacteria and infection occurs. Often, by the time a person develops symptoms, the earlier "inciting" infection has been cured or has gone into remission in chronic cases, so determining the initial cause becomes difficult.
Typical symptoms of reactive arthritis include: inflammatory arthritis of the large joints, inflammation of the eye in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women.
Signs and symptoms
Because common systems involve the eyes, urinary system, and hands and feet, a clinical mnemonic for reactive arthritis is "can't see, can't pee, can't climb a tree." The typical triad of symptoms includes:
- Conjunctivitis
- Nongonococcal urethritis Asymmetric oligoarthritis
Symptoms usually appear within 1 to 3 weeks of known infection but may be delayed by 4 to 35 days. The classic presentation of the syndrome usually begins with urinary symptoms, such as a burning sensation during urination or increased frequency of urination. Other genitourinary problems may occur, such as prostatitis in men and cervicitis, salpingitis, and/or vulvovaginitis in women.
People may develop monoarthritis, which affects large joints such as the knees and sacral joints, causing pain and swelling. Some patients may also experience Achilles tendinitis, along with heel or plantar fasciitis, and even Penis Lesions are common.
Causes of Disease
Reactive arthritis is associated with the HLA-B27 gene and is often triggered by a previous infection. In the United States, the most common triggering infection is a genital tract infection associated with Chlamydia trachomatis. Other bacteria known to cause the disease worldwide include: Ureaplasma urealyticum, Salmonella spp., Shigella spp., Yersinia spp., and Campylobacter spp.
Commonly, food poisoning or enteric infection may be the cause of the illness, especially Shigella, which is a common pathogen that causes reactive arthritis after diarrhea.
Diagnostic Methods
The diagnosis of reactive arthritis mainly relies on clinical symptoms, especially swelling and redness and heat of the joints. In some cases, your doctor may swab the urethra, cervix, and throat to grow the causative organism. Urine and stool samples may also be tested, or an arthrocentesis of the joint cavity may be done to obtain fluid for testing.
Further testing may include C-reactive protein and erythrocyte sedimentation rate testing, which are nonspecific tests that can help confirm the diagnosis of the syndrome. Also, a blood test to check for the HLA-B27 gene may help with diagnosis; about 75% of people with reactive arthritis have this gene.
Treatment options
The main goals of treatment are to identify and eliminate the underlying source of infection, using appropriate antibiotics when necessary. If there are no signs of infection, treatment is focused on relieving each problem. For nonspecific urethritis, your doctor may prescribe a short course of tetracycline antibiotics.
When it comes to pain management, the use of NSAIDs (non-steroidal anti-inflammatory drugs) is quite common. For patients with more severe reactive symptoms that do not respond to other treatments, steroids, sulfasalazine, and immunosuppressants may be needed. Topical steroids are indicated for the occurrence of iritis.
Prognosis and epidemiology
The prognosis of reactive arthritis may vary from self-limited to frequently relapsing or chronic. Most patients develop severe symptoms within a few weeks to six months. According to studies, 15% to 30% of cases may develop into chronic arthritis or sacral inflammation.
Nevertheless, most people with reactive arthritis can expect to live a normal lifespan and maintain a nearly normal lifestyle with only modest adjustments to the affected organs. This information makes us think: Do you have enough knowledge and awareness about your own health?
