Summary about Disease
Reiter's Syndrome, now more commonly referred to as Reactive Arthritis, is a type of arthritis that occurs as a reaction to an infection in the body. Often, the infection is in the urinary tract, genitals, or intestines. It typically affects the joints, eyes, and urethra (the tube that carries urine out of the body). Reactive arthritis is not contagious.
Symptoms
Symptoms typically include:
Joint pain and stiffness: Commonly affects the knees, ankles, and feet.
Eye inflammation (Conjunctivitis): Causes redness, itching, and discharge.
Urinary problems (Urethritis): Painful urination, discharge.
Skin rash: Small, painless ulcers on the penis (balanitis), or thick, scaly skin on the palms and soles (keratoderma blennorrhagicum).
Mouth sores: Small, painless sores inside the mouth.
Enthesitis: Pain where tendons and ligaments attach to bone, especially in the heel.
Causes
Reactive arthritis is triggered by an infection, often bacterial. Common triggering infections include:
Chlamydia trachomatis (sexually transmitted infection)
Salmonella, *Shigella*, *Yersinia*, and *Campylobacter* (food poisoning) The exact mechanism by which these infections trigger arthritis is not fully understood, but it's believed to involve an autoimmune response. Genetic factors, particularly the presence of the HLA-B27 gene, increase the risk of developing reactive arthritis after exposure to these infections.
Medicine Used
4. Medicine used Treatment focuses on relieving symptoms and managing the underlying infection. Medications used may include:
Antibiotics: To treat the triggering infection (if present).
Nonsteroidal anti-inflammatory drugs (NSAIDs): To relieve pain and inflammation. Examples include ibuprofen and naproxen.
Corticosteroids: To reduce inflammation, either injected into affected joints or taken orally.
Disease-modifying antirheumatic drugs (DMARDs): Such as sulfasalazine or methotrexate, may be used for persistent or severe arthritis.
Tumor necrosis factor (TNF) blockers: In severe cases to help reduce inflammation
Is Communicable
Reactive arthritis itself is not communicable. However, the triggering infections (like *Chlamydia*, *Salmonella*, etc.) *are* communicable. You cannot "catch" reactive arthritis from someone, but you can get an infection that then triggers the condition.
Precautions
Precautions focus on preventing the infections that can trigger reactive arthritis:
Safe sex practices: Using condoms can reduce the risk of Chlamydia and other sexually transmitted infections.
Proper food handling: Thoroughly cook food, wash hands frequently, and avoid cross-contamination to prevent food poisoning from bacteria like Salmonella and *Shigella*.
Avoid known triggers: If you have had reactive arthritis triggered by a specific infection in the past, try to avoid exposure to that infection again.
How long does an outbreak last?
The duration of reactive arthritis varies. In many cases, symptoms resolve within a few months (acute reactive arthritis). However, some individuals experience chronic or recurrent symptoms lasting for several months to years (chronic reactive arthritis).
How is it diagnosed?
Diagnosis is based on a combination of factors:
Medical history: Including recent infections or risk factors for infections.
Physical examination: Assessing joint pain, eye inflammation, skin rashes, and other symptoms.
Laboratory tests:
Blood tests: To check for inflammation markers (ESR, CRP), the HLA-B27 gene, and signs of infection.
Urine tests: To check for infection.
Joint fluid analysis: To rule out other causes of arthritis.
Swabs: To check for infection
Imaging: X-rays of affected joints may be used to look for damage.
Timeline of Symptoms
9. Timeline of symptoms The typical timeline is as follows: 1. Infection: Individual contracts an infection like Chlamydia, *Salmonella*, etc. 2. Latent period: A period of 1-4 weeks may pass after the infection before arthritis symptoms appear. 3. Acute phase: Joint pain, eye inflammation, urinary symptoms, and skin rashes develop. This phase typically lasts for several weeks to months. 4. Resolution: Symptoms gradually improve and eventually resolve in many cases. 5. Chronic phase (in some individuals): Symptoms persist for longer than 6 months or recur intermittently.
Important Considerations
HLA-B27: While the HLA-B27 gene is associated with reactive arthritis, not everyone with the gene will develop the condition.
Early diagnosis and treatment: Early treatment of the triggering infection and management of symptoms can improve outcomes and prevent long-term complications.
Long-term follow-up: Individuals with chronic reactive arthritis may require ongoing monitoring and treatment by a rheumatologist.
Impact on quality of life: Reactive arthritis can significantly impact quality of life due to pain, stiffness, and other symptoms. Support groups and coping strategies can be helpful.
Differentiating other diseases: The symptoms of reactive arthritis can be similar to other types of arthritis so it is vital that a healthcare professional provide you with a diagnosis and treatment plan.