Reiter's syndrome (reactive arthritis)

General or Other | Rheumatology | Reiter's syndrome (reactive arthritis) (Disease)


Description

Reactive arthritis (Reiter's syndrome or Reiter's arthritis), is classified as an autoimmune condition that develops in response to an infection in another part of the body (cross-reactivity). Coming into contact with bacteria and developing an infection can trigger the disease.

Reiter's syndrome has symptoms similar to various other conditions collectively known as arthritis. By the time the patient presents with symptoms, oftentimes the trigger infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.

The triad of symptoms include: an inflammatory arthritis of large joints including commonly the knee and the back (due to involvement of the sacroiliac joint), inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Patients can also present with mucocutaneous lesions, as well as psoriasis-like skin lesions such as circinate balanitis, and keratoderma blennorrhagica. Enthesitis can involve the Achilles tendon resulting in heel pain.

Not all affected persons have all the manifestations, and the formal definition of the disease is the occurrence of otherwise unexplained non-infectious inflammatory arthritis combined with urethritis in men, or cervicitis in women.

Causes and Risk factors

Reactive arthritis most commonly strikes individuals aged 20–40 years of age and is more common in men than in women. Patients with HIV have an increased risk of developing reactive arthritis as well.

Diagnosis and Treatment

The objective of treatment is to reduce joint pain and inflammation; prevent or decrease the amount of joint damage; and restore the function of damaged joints. Treatment includes medications, rest, joint protection, and special exercises.

The most common drugs used are non-steroidal anti-inflammatory drugs (NSAIDS). In severe cases, folic acid antagonists such as methotrexate may relieve joint inflammation.

In addition to medications, splints may be prescribed to limit movement, as this protects joints. Special exercises are recommended to maintain muscle strength and increase the range of motion. ...