Pathogenesis (disease development) Reactive arthritis is a secondary disease after gastrointestinal (stomach and intestinal tract), urogenital (urinary and genital), or pulmonary (lung) infections. It refers to joint involvement in which pathogens are (usually) not found in the joint (sterile synovitis/articular synovitis). It typically affects unilaterally (unilaterally) single large joints of the lower extremity. However, bacterial … Reactive Arthritis: Causes
Therapeutic target Symptomatic therapy of the symptoms Therapy recommendations Symptomatic therapy: Anti-inflammatories: e.g., ibuprofen (non-steroidal anti-inflammatory drugs, NSAIDs); prednisolone (glucocorticoids). For peripheral arthritis: sulfasalazine (DMARDs; disease-modifying anti-rheumatic drugs); also methotrexate (immunosuppressants), if necessary. If necessary, elimination of pathogens, in the case of continued existence of urethritis (urethritis)/enteritis (inflammation of the intestine)/infections of the respiratory tract … Reactive Arthritis: Drug Therapy
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnosis. Conventional radiographs of the affected joints
The following symptoms and complaints may indicate reactive arthritis/Reiter’s disease: Reiter’s triad Acute arthritis* (joint inflammation) – often asymmetric mono- or oligoarthritis (one or fewer than five joints; very rarely polyarthritis); aseptic (“germ-free”); localization: Mostly large joints of the lower extremity (hip, knee, and ankle joints). less frequently: Toe, hand or finger joints. Shoulder or … Reactive Arthritis: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of reactive arthritis/Reiter’s disease. Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Current medical history/systemic history … Reactive Arthritis: Medical History
Eyes and ocular appendages (H00-H59). Conjunctivitis (inflammation of the conjunctiva), unspecified. Musculoskeletal system and connective tissue (M00-M99). Lyme arthritis – inflammation of the joints caused by the bacterium Borrelia; occurring in the context of Lyme disease. Post-streptococcal arthritis – joint inflammation occurring after streptococcal infection. Causes (external) of morbidity and mortality (V01-Y84). Urethritis (inflammation of … Reactive Arthritis: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by HLA-B27-associated reactive arthritis: Mouth, esophagus (food pipe), stomach, and intestine (K00-K67; K90-K93). Chronification of joint symptoms Ankylosing spondylitis (ankylosing spondylitis) – chronic inflammatory rheumatic disease associated with pain and stiffness of the spine.
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Skin (Normal: intact) [Erythema nodosum (nodular erysipelas), localization: both extensor sides of the lower leg, on the knee and ankle joints; less frequently on the arms or buttocks, Keratoderma … Reactive Arthritis: Examination
1st order laboratory parameters – obligatory laboratory tests. Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate) [moderately to markedly elevated]. Pathogen detection – succeeds in most cases already subsided infection rarely; detection from morning urine or stool. Detection of the HLA-B27 allele in the HLA-B gene (variant of the human protein complex … Reactive Arthritis: Test and Diagnosis
