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Reactive Arthritis (Reiter’s syndrome)

Reactive Arthritis (Reiter’s syndrome)

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Pathology

A seronegative oligoarthritis is a type of pathology which typically develops 2-6 weeks after an infection. This type of infection is usually related to a genitourinary or gastrointestinal infection.

Aetiology

Generally, this type of condition presents itself between the ages of 15-25, with males more likely to be affected than females. Furthermore, it is often associated with HLA B27.

Symptoms

The typical symptoms associated with this type of pathology include urethritis, conjunctivitis, and arthritis, in addition to malaise, fever, lower back pain, and heel pain due to enthesopathies at the Achilles tendon.

Signs

  • Joint swelling
  • Dactylitis
  • Circinate balanitis
  • Keratoderma blennorrhagica

Investigations

  • Bloods: FBC, U&E, ESR, CRP, Rheumatoid Factor
  • Microbiology: Urine and vaginal/urethral swabs for chlamydia, stool culture
  • Joint Aspiration: To rule out crystals or septic arthritis

Treatment

Conservative: Rest

Medical: NSAIDs, intra-articular or oral steroids, antibiotics to treat underlying infection. DMARDs may also be used for chronic cases.

Complications

Thirty percent of cases experience recurrent symptoms.

Prognosis

This type of condition may run a chronic/relapsing course, however, around seventy percent of cases will typically fully recover within 6 months.

Rectangle: Rounded Corners: NOTE FOR PUBLISHERS –     Image showing both Circinate Balanitis and Keratoderma Blennorrhagica

Figure 8.2 Circinate Balanitis and Keratoderma Blennorrhagica

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