Reactive arthritis

Description

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

This condition is usually the objectives of the knees, ankles, and feet. The inflammation can also affect the eyes, the skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis is sometimes called Reiter's syndrome.

Reactive arthritis is common. For most people, the signs and symptoms come and go, in the end they will disappear in a period of 12 months.

Symptoms

The signs and symptoms of reactive arthritis usually begin 1 to 4 weeks after exposure to an activation of the infection. These could include:

  • The pain and stiffness. The pain in the joints associated with reactive arthritis occurs more frequently in the knees, ankles, and feet. The pain also can occur on the heels, back, or buttocks.
  • Inflammation of the eyes. Many people who have reactive arthritis also develop inflammation of the eyes (conjunctivitis).
  • Urinary problems. The increase of the frequency and discomfort during urination may occur, such as inflammation of the prostate gland or neck of the uterus.
  • The inflammation of the tendons and ligaments, where they attach to the bone (enthesitis). This happens most often in the heels and the soles of the feet.
  • Swollen toes or fingers. In some cases, the toes or the fingers could become so swollen that they were like sausages.
  • Problems of the skin. Reactive arthritis can affect the skin in a variety of ways, including sores in the mouth and a rash on the soles of the feet and palms of the hands.
  • The low back pain. The pain tends to be worse at night or in the morning.

When to see a doctor

If you develop pain in the joints within a month of having diarrhea, or a genital infection, contact your health care provider.

Causes

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

Many bacteria can cause reactive arthritis. Some are transmitted by sexual intercourse, and others are food-borne. The most common include:

  • Campylobacter
  • Chlamydia
  • Clostridioides difficile
  • Escherichia coli
  • Salmonella
  • Shigella
  • Yersinia

Reactive arthritis is not contagious. However, the bacteria that cause it can be transmitted sexually or from contaminated food. Only a few of the people who are exposed to these bacteria will develop reactive arthritis.

Risk factors

Certain factors increase the risk of reactive arthritis:

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

Prevention

Genetic factors appear to play a role in whether you are likely to develop reactive arthritis. Although you can't change your genetic makeup, you can reduce your exposure to bacteria that can lead to reactive arthritis.

Storing food at proper temperatures and cook it properly. By doing these things, you will help prevent many foodborne bacteria that can cause reactive arthritis, such as salmonella, shigella, yersinia and campylobacter. Some sexually transmitted infections can trigger reactive arthritis. The use of condoms to help reduce your risk.

Reactive arthritis

Diagnosis

During the physical exam, your doctor is likely to check your joints, swelling, heat and tenderness, and the test of range of motion in the spine and the joints affected. Your doctor can also check your eyes for the inflammation and the skin to treat rashes.

Blood tests

Your doctor may recommend a blood sample to be tested for:

  • The evidence of past or current infection
  • The signs of inflammation
  • Antibodies associated with other types of arthritis
  • A genetic marker linked to reactive arthritis

The joint fluid tests

Your doctor may use a needle to withdraw a sample of fluid from within an affected joint. This fluid will be tested for:

  • White blood cell count. An increase in the number of white blood cells may indicate an inflammation or an infection.
  • Infections. The bacteria in the joint fluid may indicate septic arthritis, which can result in serious damage to the joints.
  • Crystals. Uric acid crystals in the joint fluid could indicate gout. This very painful type of arthritis often affects the big toe.

Imaging tests

X-rays of his lower back, the pelvis and the joints can indicate if you have any of the characteristic signs of reactive arthritis. X-rays can also rule out other types of arthritis.

Treatment

The goal of treatment is to control symptoms and treatment of an infection that may be present.

Drugs

If your reactive arthritis was caused by a bacterial infection, the doctor may prescribe an antibiotic if there is evidence of persistent infection. The antibiotics that you take depends on the bacteria that are present.

The signs and symptoms of reactive arthritis can be alleviated with:

  • Nonsteroidal anti-inflammatory drugs (Nsaids). The prescription of nonsteroidal anti-inflammatory drugs (Nsaids) such as indomethacin (Indocin), can relieve the inflammation and pain of arthritis reactive.
  • Steroids. A steroid injection into the affected joint can reduce the inflammation and allow you to return to your usual level of activity. Steroid eye drops may be used for symptoms of the eye, and steroid creams can be used for skin rashes.
  • The rheumatoid arthritis drugs. The limited evidence suggests that drugs such as sulfasalazine (Azulfidine), methotrexate (Trexall), or etanercept (Enbrel) can alleviate the pain and stiffness of some people with reactive arthritis.

Physical therapy

A physical therapist can provide you with targeted exercises for the joints and muscles. Strengthening exercises increase the articulation of the support for the development of the muscles around the affected joints. The range of motion exercises can increase your joint flexibility and reduce stiffness.

Preparing for your appointment

It is likely to start by seeing your primary care provider, who may refer you to a doctor that specializes in arthritis (rheumatologist) for further evaluation.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment
  • Key personal information, including your medical history and your family's medical history
  • All the medications, vitamins, or other supplements you are taking, including dose
  • Questions to ask the doctor

Have a friend or family member, if possible, to help you remember the information they give you. For reactive arthritis, basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • What are other possible causes?
  • What tests do I need?
  • What treatment approach do you recommend?
  • How soon do you expect that my symptoms improve with treatment?
  • Is there anything I can do right now to help relieve my pain in the joints?
  • Am I at risk of long-term complications of this condition?
  • I have these other health conditions. How can I best manage them together?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • When did your symptoms begin?
  • Have been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Have had a recent infection?
Symptoms and treatment of Reactive arthritis