(the syndrome of Reactive arthritis pictured left)Reactive Arthritis - (formerly known as Reiter's Syndrome)
What is it? A post infectious immunologic phenomenon resulting in arthritis.
How long after an infection does it develop? a few days to a few weeks. This lag-time may make it difficult to know what the offending pathogen was.
Which pathogens are associated? Think about two big systems....GI and GU
- GI: Yersinia, Salmonella, Shigella, Campylobacter
- GU: Chlamydia, and possibly Gonorrhea
What does the syndrome look like? The arthritis is usually an asymmetric oligoarthritis,. Enthesitis is common and may affect the achilles tendon or plantar fascia on the calcaneus. Conjunctivitis or uveitis is seen, as is balanitis - Hence the adage "Can't pee, can't see, can't climb a tree". A classic dematologic manifestation of reactive arthritis is keratoderma blennorrhagica - scaly lesions on the palms and soles. See picture below.
Is there any genetic predisposition to developing Reactive Arthritis? Yes.
What is it? HLA-B27 is present in just under 50%.
How do we treat it? NSAIDs work well, like indomethacin or naproxen. In severe cases, DMARDs like sulfasalazine may be used.
Why is it called Reactive Arthritis now instead of Reiter's Syndrome? an interesting paper can be found here.
(keratoderma blennorrhagica pictured left)
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