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What is Reactive Arthritis?

Reactive arthritis, formerly known as Reiter's syndrome, is a type of arthritis that develops in response to an infection in another area of the body, most commonly the intestines, genitals, or urinary tract. In most instances, it resolves within a few months and causes no long-term issues. Women and men of any age can develop this condition, but it is more prevalent in men, and individuals aged between 20 and 40.

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Causes of Reactive Arthritis

Reactive arthritis can be caused by a variety of microorganisms. Some are sexually transmitted, while others are spread by food. Campylobacter, Chlamydia, Clostridioides difficile, Escherichia coli, Salmonella, Shigella, and Yersinia are a few of them. Genes may also potentially have a role in reactive arthritis as a specific type of gene called the HLA-B27 gene is frequently found in people with reactive arthritis. However, many people with this gene do not get this condition.

Some of the risk factors for reactive arthritis include:

  • Infection from sexual contact
  • Illness from contaminated food
  • Being male
  • Hereditary factors

Signs and Symptoms of Reactive Arthritis

The signs and symptoms of reactive arthritis include:

  • Pain and stiffness in knees, ankles, feet, heels, low back, or buttocks
  • Eye inflammation
  • Urinary problems
  • Inflammation of tendons and ligaments where they attach to bone
  • Swollen toes or fingers
  • Skin problems
  • Low back pain

Diagnosis of Reactive Arthritis

Your doctor will review your symptoms and medical history and perform a thorough physical examination to look for swelling and tenderness and to assess the range of motion, stability, and strength of the joint. Additional tests may be ordered to rule out other causes of your symptoms and confirm the diagnosis, including:

  • X-rays: X-rays are used to check for bone abnormalities such as joint swelling or injury. This can be used to screen for diagnosing spondylitis or sacroiliitis.
  • Blood tests: Blood tests are performed to look for certain substances in the blood that can indicate infection, inflammation, and antibodies associated with reactive arthritis.
  • Tests for Infections: This includes a test for chlamydia and other infections linked to reactive arthritis.
  • Joint Fluid Tests: Your doctor may aspirate a sample of fluid from within an affected joint with a special needle and syringe. The fluid in your joint will be analyzed for white blood cell count, infection, and uric acid crystals.
  • Gene Testing: This test may be done to check for the HLA-B27 gene. Reactive arthritis patients have a higher prevalence of this gene. However, not everyone with this gene develops reactive arthritis.
  • Erythrocyte Sedimentation Rate (ESR or SED rate): The speed at which red blood cells sink to the bottom of a test tube is measured in this test. Proteins in the blood clump together and become heavier than normal when edema and inflammation are present causing them to settle faster at the bottom of the test tube.

Treatment for Reactive Arthritis

The treatment will depend on your symptoms, age, overall health, and severity of the condition. The various options involved to treat signs and symptoms associated with reactive arthritis include:

  • Antibiotics to treat the infection
  • Steroid eye drops to treat vision problems
  • Steroid creams to treat skin rashes
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen to reduce pain and inflammation
  • Steroid injection to the affected joint to reduce inflammation and improve joint motion
  • Rheumatoid arthritis medication such as sulfasalazine and methotrexate for those with chronic joint pain and stiffness
  • Rest to reduce pain and inflammation
  • Muscle strengthening and joint function exercises to improve joint strength and mobility

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