Reactive arthritis, also known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the body. It is a complex condition that affects multiple systems, including rheumatology and internal medicine. In this topic cluster, we will explore the characteristic features of reactive arthritis, including its symptoms, causes, diagnosis, treatment, and management.
Symptoms of Reactive Arthritis
Reactive arthritis typically presents with a triad of symptoms:
- Arthritis: This includes joint pain, swelling, and stiffness, commonly affecting the lower limbs, especially the knees and ankles.
- Uveitis: Inflammation of the eye's middle layer, leading to redness, pain, and blurred vision.
- Genitourinary Symptoms: These may include urethritis (inflammation of the urethra) or cervicitis (inflammation of the cervix) caused by sexually transmitted infections.
Other symptoms may include skin rashes, mouth ulcers, and swelling of the fingers and toes. The onset of reactive arthritis is often acute and may follow a gastrointestinal or genitourinary infection.
Causes of Reactive Arthritis
Reactive arthritis is thought to be triggered by an infection in another part of the body, typically the gastrointestinal or genitourinary tract. The condition is often linked to certain bacterial infections, such as:
- Chlamydia trachomatis (a sexually transmitted bacterium)
- Salmonella (a foodborne bacterium)
- Shigella (a bacterium that causes dysentery)
- Yersinia (a bacterium found in contaminated food or water)
These infections can trigger an abnormal immune response in susceptible individuals, leading to the development of reactive arthritis.
Diagnosis of Reactive Arthritis
Diagnosing reactive arthritis can be challenging, as the symptoms may resemble those of other rheumatic conditions. A thorough medical history and physical examination are essential in evaluating a possible diagnosis of reactive arthritis. Laboratory tests, including blood tests for inflammatory markers and tests for specific infections, may help confirm the diagnosis.
Imaging studies, such as X-rays and ultrasound, can assess joint involvement and detect characteristic changes associated with reactive arthritis. In some cases, a synovial fluid analysis may be performed to rule out other causes of joint inflammation.
Treatment and Management of Reactive Arthritis
There is no specific cure for reactive arthritis, and treatment aims to relieve symptoms, control inflammation, and prevent recurrence. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to help reduce pain and inflammation in the affected joints.
In cases of severe joint inflammation, corticosteroid injections may be considered. Disease-modifying antirheumatic drugs (DMARDs) or biologic agents may be recommended for individuals with persistent or recurrent symptoms.
Physical therapy and exercises are important components of the management plan, as they help improve joint mobility and reduce stiffness. In addition, patient education on self-management strategies, including the importance of maintaining a healthy lifestyle and managing stress, can contribute to long-term well-being.
Conclusion
Reactive arthritis is a complex condition with characteristic features that span across rheumatology and internal medicine. Understanding the symptoms, causes, diagnosis, treatment, and management of reactive arthritis is crucial for healthcare professionals in providing comprehensive care for individuals affected by this condition.