Reactive Arthritis

What is Reactive Arthritis?
Reactive arthritis is a type of arthritis that causes joint pain and swelling due to an infection, which may be in the intestines, genitals, or urinary tract.

Who is most at risk for Reactive Arthritis?

• This disease mainly affects men between the ages of 20 and 40 because they are more at risk of urethral infections caused by sexually transmitted diseases.

• However, the disease may appear at any age and in anyone.

• We are all at risk of intestinal infection through food poisoning, which may lead to reactive arthritis.

• One in every 10 people in the world has a gene called HLA-B27, and about three out of every four people with reactive arthritis have this gene.

• Thus, this gene appears to make you more susceptible to developing reactive arthritis if you have the triggering infection.

What causes Reactive Arthritis?
Symptoms of reactive arthritis usually begin to appear about 1 to 3 weeks after infection. Reactive arthritis is most often associated with the bacterium Chlamydia trachomatis, which is usually contracted through sexual contact. Gastrointestinal infections such as Salmonella, Shigella, Yersinia, and Campylobacter can also lead to reactive arthritis. People may contract these bacteria after eating or handling improperly prepared food, such as meat not stored at the proper temperature. Test results show that nearly 80% of people with reactive arthritis test positive for the HLA-B27 gene. However, inheriting the HLA-B27 gene does not necessarily mean you will develop reactive arthritis. Eight percent of healthy people have the HLA-B27 gene, and only about five percent of them will develop reactive arthritis if exposed to the triggering infection.

What are the symptoms of Reactive Arthritis?

• Reactive arthritis often affects the genitourinary system, including the prostate or urethra in men, and the urethra, uterus, or vagina in women.

• Men may notice increased urinary frequency, a burning sensation when urinating, and discharge from the penis. Some men with reactive arthritis develop prostatitis. Symptoms of prostatitis include fever and chills along with increased urinary frequency and burning on urination.

• Women with reactive arthritis may develop genitourinary tract problems such as cervicitis or urethritis (inflammation of the urethra), which can cause burning during urination. Additionally, some women also develop salpingitis (inflammation of the fallopian tubes) or vulvovaginitis. These conditions can sometimes cause arthritis.

• The arthritis associated with reactive arthritis typically involves pain and swelling in the knees, ankles, and feet. The wrists, fingers, and other joints are often less frequently affected.

• Individuals with reactive arthritis often develop inflammation of the tendons or at the sites where tendons attach to bone (enthesitis). This leads, in many people with reactive arthritis, to heel pain or irritation of the Achilles tendon at the back of the ankle.

• Reactive arthritis can also cause spondylitis (inflammation of the spinal vertebrae) or sacroiliitis (inflammation of the joints in the lower back that connect the spine to the pelvis).

• Conjunctivitis, inflammation of the mucous membrane covering the eyeball and eyelid, occurs in nearly half of people with reactive arthritis. Some individuals may develop uveitis, inflammation of the inner eye. Both conjunctivitis and uveitis can cause red eyes, eye pain and irritation, and blurred vision.

• Between 20% and 40% of men with reactive arthritis develop small, shallow, painful ulcers on the tip of the penis. A small percentage of men and women develop a rash or small, hard nodules on the soles of the feet, and less often on the palms of the hands or elsewhere.

How is Reactive Arthritis diagnosed?

• The most reliable method for diagnosing reactive arthritis is identifying the bacterial cause in stool or urine.

• Blood tests may be helpful but are not as specific as testing for bacteria in stool or urine.

What is the treatment for Reactive Arthritis?

• If the causative agent is urethritis, a short course of antibiotics is usually recommended.

• Intestinal infection is often detected at the time of reactive arthritis symptoms, but if a stool sample shows that bacteria are still present, then treatment to eliminate them may be recommended.

• Anti-inflammatory pain relievers help relieve pain and stiffness.

• A steroid injection given directly into the joint is an option in cases of severe joint inflammation.

• Physical therapy helps keep joints mobile. It also helps keep muscles around affected joints strong if you are not using the joint much.

• If symptoms last more than a few months or if other treatments are not effective, disease-modifying medications are recommended. These medications aim to reduce harmful effects on the joints.