Language
Country/Area
No result found
The surprising trilogy of reactive arthritis: how are the eyes, urinary tract, and joint disease connected?
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 condition often develops after the infection is relatively cured or in remission, making it difficult to diagnose the underlying cause of the illness. Reactive arthritis is often accompanied by other characteristic symptoms, including eye inflammation, urethritis, and joint swelling and pain. The combination of these symptoms makes the name "reactive arthritis" more reasonable.
The classic triad of reactive arthritis includes: proliferative arthritis, inflammation of the large joints, and inflammation of the eyes, such as conjunctivitis or uveitis.
The specific symptoms of reactive arthritis can include urethral discomfort, red and swollen eyes, and swollen and painful joints, which makes people unconsciously link these three parts together. According to statistics, the condition is most common in young adults aged 20 to 40 years old, and is more common in men than in women. The onset of this disease is usually related to bacterial infection of the intestinal or urogenital tract, among which Salmonella, Shigella and Chlamydia are the main pathogens.
Symptoms of reactive arthritis
The symptoms of reactive arthritis can be described in one sentence: "I can't see, I can't pee, I can't climb a tree." This clinical mnemonic covers the basic features of the condition: eye lesions, urethritis, and asymmetry. Arthritis. These three symptoms usually begin to appear 1 to 3 weeks after exposure to the source of infection, but may be delayed to more than 35 days.
The classic presentation begins with urethral symptoms, such as burning during urination or frequent urination, and may be followed by other genitourinary problems such as prostatitis or, in women, cervicitis.
Also, patients may experience inflammation in a single large joint, usually the knee or hip, while smaller joints such as the wrist and fingers are relatively spared. Some patients may also develop enthesitis, causing Achilles tendon pain, or plantar fasciitis. About 20% to 40% of men will develop skin lesions such as balanitis annularis.
Causes of Reactive Arthritis
The main causes of reactive arthritis are infection, especially genital tract infection due to chlamydia and infection with intestinal bacteria. Studies have shown that the presence of the HLA-B27 gene makes a person more susceptible to developing the disease. In the United States, the most common cause is chlamydia, but worldwide, salmonella and shigella are also very common. The disease begins to appear approximately 1 to 3 weeks after infection, but sometimes it may be as late as several weeks later. The specific pathogenesis is still unclear.
Treatment and PrognosisThe diagnosis of reactive arthritis is usually based on clinical symptoms, especially the presence of arthritis symptoms, and may be combined with testing of urine and stool samples.
Treatment of reactive arthritis focuses on finding and eliminating the underlying source of infection. If infection persists, appropriate antibiotics are used; if the infection cannot be found, treatment is focused on relieving symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to relieve pain and inflammation, and for patients with severe disease that does not respond to other treatments, steroids or immunosuppressants may be needed.
The course of reactive arthritis is self-limited in most patients, although some may develop chronic or recurrent episodes. Studies have found that about 15% to 30% of patients may eventually develop more devastating conditions such as ankylosing spondylitis.
The prevalence of reactive arthritis is difficult to determine because it is less commonly diagnosed in women, but studies have shown that the incidence rate in Norway was 4.6 to 5 cases per 100,000 people during a certain period, indicating that the disease The universality of cannot be ignored.
These complex symptoms and pathogenic mechanisms make reactive arthritis an important but often neglected disease in clinical practice. Our understanding of this disease is still limited. Whether we can uncover its mystery in the future is worth our attention. Deep thought and hard work?