Reactive arthritis (formerly called “Reiter’s syndrome”) is a rare form of arthritis. Here we will be discussing what causes this disease, what makes it different from “regular” or osteoarthritis, and how it can be treated?
Reactive Arthritis Causes and Risk Factors
Reactive arthritis is a form of arthritis that is associated with certain types of infections. Two common infections that could lead to reactive arthritis are sexually transmitted diseases (STDs) and gastrointestinal infections, such as food poisoning. The types of bacteria that may cause reactive arthritis include chlamydia (sexually transmitted), salmonella (foodborne), and yersinia (foodborne).
Only a very few people who have such infections get reactive arthritis. People with a genetic risk factor (presence of a gene marker–HLA B 27) are at high risk for this disease. Young males between the ages of 20-40 years are at high risk for reactive arthritis following an STD. Both genders are equally likely to get it following infections that cause diarrhea.
Symptoms of reactive arthritis
Reactive arthritis affects the joints and the tendons around the joints, usually those in the lower extremities. It could also cause inflammation in the eyes, mucosa, and the skin. Symptoms of reactive arthritis may include:
- Joint pain, swelling, and stiffness
- Swelling of finger or toes
- Low grade fever
- Severe fatigue
- Skin rash
- Mouth sores
- Inflammation of urethra (presenting with increased frequency and/or painful urination)
- Low back pain
- Eye inflammation (redness, pain, blurry vision)
For many people with reactive arthritis, symptoms resolve within 3-4 months. However, around 50% continue to have joint inflammation and other symptoms for more than a year, increasing the risk of joint damage. Symptoms may be persistent, or they may come and go. These patients need long-term treatment.
I think I have reactive arthritis. What should I do?
If you’ve been experiencing symptoms of reactive arthritis, make an appointment with your primary care physician. If your symptoms have lasted for several months, please see a rheumatologist . Your doctor will make a diagnosis based on the history and physical examination. There is no one standard test to diagnose this condition. Your doctor may:
- Test your joints for inflammation
- Order a blood or urine test
- Perform a joint fluid test
- Order an x-ray examination
Once your diagnosis is confirmed, you can begin treatment.
Treating reactive arthritis
The treatment of reactive arthritis depends on the phase of your disease and how severe are your symptoms. The treatment could include antibiotic, or anti-inflammatory drugs, and occasionally, steroids. Some common drugs prescribed to treat reactive arthritis include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). They could reduce inflammation and pain.
- Corticosteroids. These could be delivered by mouth or by injection into the affected joint.
- Disease-modifying anti-rheumatic drugs (DMARDs). These are rarely used but may be considered when you do not respond to the above treatments and symptoms persist for several months. These drugs can weaken the immune system and increase your risk for contracting infections, so they should be used carefully.
In addition to the above, exercise is encouraged to promote healthy joints and reduce symptoms. Eating a healthy diet and controlling your weight can also relieve stiffness in your joints. Work with your doctor to determine which of these treatments can help you best.
Written by Natan Rosenfeld