Reactive arthritis, also known as Reiter's syndrome, is a form of inflammatory arthritis[1] 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.[2] By the time the patient presents with symptoms, often the "trigger" infection has been cured or is in remission in chronic cases, thus making determination of the initial cause difficult.
The arthritis often is coupled with other characteristic symptoms; this has been called Reiter's syndrome, Reiter's disease or Reiter's arthritis. The term "reactive arthritis" is increasingly used as a substitute for this designation because of Hans Reiter's war crimes with the Nazi Party.
The manifestations of reactive arthritis include the following triad of symptoms: an inflammatory arthritis of large joints, inflammation of the eyes in the form of conjunctivitis or uveitis, and urethritis in men or cervicitis in women. Arthritis occurring alone following sexual exposure or enteric infection is also known as reactive arthritis. Patients can also present with mucocutaneous lesions, as well as psoriasis-like skin lesions such as circinate balanitis, and keratoderma blennorrhagicum. Enthesitis can involve the Achilles tendon resulting in heel pain.[3] Not all affected persons have all the manifestations.
The clinical pattern of reactive arthritis commonly consists of an inflammation of fewer than five joints which often includes the knee or sacroiliac joint. The arthritis may be "additive" (more joints become inflamed in addition to the primarily affected one) or "migratory" (new joints become inflamed after the initially inflamed site has already improved).[4][5]
Reactive arthritis is an RF-seronegative, HLA-B27-linked arthritis[6] often precipitated by genitourinary or gastrointestinal infections. The most common triggers are intestinal infections (with Salmonella, Shigella or Campylobacter) and sexually transmitted infections (with Chlamydia trachomatis);[7] however, it also can happen after group A streptococcal infections.[8][9]
It most commonly strikes individuals aged 20–40 years of age, is more common in men than in women, and more common in white than in black people. This is owing to the high frequency of the HLA-B27 gene in the white population.[10][11] It can occur in epidemic form. Patients with HIV have an increased risk of developing reactive arthritis as well.
Numerous cases during World Wars I and II focused attention on the triad of arthritis, urethritis, and conjunctivitis (often with additional mucocutaneous lesions), which at that time was also referred to as Fiessenger–Leroy–Reiter syndrome.[12]
^American College of Rheumatology. "Reactive Arthritis". Retrieved 24 January 2017.
^Mayo Staff (5 March 2011). "Reactive Arthritis (Reiter's Syndrome)". Mayo Clinic. Retrieved 16 May 2011.
^H. Hunter Handsfield (2001). Color atlas and synopsis of sexually transmitted diseases, Volume 236. McGraw-Hill Professional. p. 148. ISBN 978-0-07-026033-7.
^Primer on the Rheumatic Diseases, By John H. Klippel, page 218
^Rheumatology in Practice, By J. A. Pereira da Silva, Anthony D. Woolf page 5.9
^Ruddy, Shaun (2001). Kelley's Textbook of Rheumatology, 6th Ed. W. B. Saunders. pp. 1055–1064. ISBN 978-0-7216-9033-9.
^Siala, Mariam; et al. (2008). "Analysis of bacterial DNA in synovial tissue of Tunisian patients with reactive and undifferentiated arthritis by broad-range PCR, cloning and sequencing". Arthritis Research & Therapy. 10 (2). BioMed Central: R40. doi:10.1186/ar2398. PMC 2453759. PMID 18412942.
^Infectious Diseases Immunization Committee (1995). "Poststreptococcal arthritis". The Canadian Journal of Infectious Diseases. 6 (3): 133–135. doi:10.1155/1995/470341. PMC 3327910. PMID 22514384.
^"Reactive Arthritis". www.rheumatology.org. Retrieved 18 September 2019.
Reactivearthritis, also known as Reiter's syndrome, is a form of inflammatory arthritis that develops in response to an infection in another part of the...
diseases. In this case, the arthritis is considered to be secondary to the main disease; these include: Psoriasis Reactivearthritis Ehlers–Danlos syndrome...
include osteoarthritis, ankylosing spondylitis, heel pad syndrome, and reactivearthritis. Most cases of plantar fasciitis resolve with time and conservative...
Acute septic arthritis, infectious arthritis, suppurative arthritis, pyogenic arthritis, osteomyelitis, or joint infection is the invasion of a joint by...
of reactivearthritis.[citation needed] Reactivearthritis is characterized by nongonococcal urethritis, conjunctivitis, and arthritis. Reactive arthritis...
ankylosing spondylitis), arthritis due to infectious causes (including Lyme disease-related arthritis), gouty arthritis, or reactivearthritis. The knee is one...
modern commentators suspect that he suffered from reactivearthritis, rather than gout. Reactivearthritis is a joint inflammation caused by intestinal bacterial...
until the 20th century and not treatable. Postinfectious arthritis, also known as reactivearthritis, and rheumatic fever are other examples. In the United...
include CPPD (pseudogout), rheumatoid arthritis, psoriatic arthritis, palindromic rheumatism, and reactivearthritis. Gouty tophi, in particular when not...
antiinflammatory drugs on the C-reactive protein level in rheumatoid arthritis: a meta-analysis of randomized controlled trials". Arthritis and Rheumatism. 64 (11):...
spondyloarthritis (including ankylosing spondylitis), psoriatic arthritis, reactivearthritis or arthritis related to inflammatory bowel diseases, including ulcerative...
syndrome Reactivearthritis: Conjunctivitis is part of the triad of reactivearthritis, which is thought to be caused by autoimmune cross-reactivity following...
Keratoderma blennorrhagicum is commonly seen as an additional feature of reactivearthritis in almost 15% of male patients. The appearance is usually of a vesico-pustular...
arthropathies, such as ankylosing spondylitis, psoriatic arthritis, and reactivearthritis. Symptoms include multiple points of tenderness at the heel...
8 September 2017. Ritchlin C, Fitzgerald I (2007). Psoriatic and ReactiveArthritis: A Companion to Rheumatology (1st ed.). Maryland Heights, MI: Mosby...
not proven to involve a self-antigen, and at least in the related reactivearthritis, which follows infections, the antigens involved are likely to be...
arthralgia is a symptom of injury, infection, illness (in particular arthritis), or an allergic reaction to medication. According to MeSH, the term "arthralgia"...
Juvenile idiopathic arthritis (JIA), formerly known as juvenile rheumatoid arthritis (JRA), is the most common chronic rheumatic disease of childhood,...
B27 arthropathies such as ankylosing spondylitis, psoriatic arthritis, and reactivearthritis. Apophysitis, inflammation of the bony attachment, generally...
cause reactivearthritis—the triad of arthritis, conjunctivitis and urethral inflammation—especially in young men. About 15,000 men develop reactive arthritis...
simplex virus Cytomegalovirus Reactivearthritis: urethritis is part of the triad of reactivearthritis, which includes arthritis, urethritis, and conjunctivitis...
hip dysplasia and leg length differences. Transient synovitis is a reactivearthritis of the hip of unknown cause. People are usually able to walk and may...
complication. But, when the arthritis is an isolated symptom, it is referred to as poststreptococcal reactivearthritis. This arthritis can involve a variety...
Global Information