Reactive Arthritis: Examination

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 blenorrhagicum – chronic recurrent pustulosis/hyperkeratotic changes on palms and soles]
    • Gait pattern (fluid, limping).
    • Body or joint posture (upright, bent, gentle posture).
    • Malpositions (deformities, contractures, shortenings).
    • Muscle atrophies (side comparison!, if necessary circumference measurements).
    • Joint (abrasions / wounds, swelling (tumor), redness (rubor), hyperthermia (calor)) [arthritis (joint inflammation)].
  • Palpation (palpation) of prominent bone points, tendons, ligaments; musculature; joint (joint effusion); soft tissue swelling; pressure pain (localization!).
    • [Dactylitis (finger/toe inflammation), especially of forefeet; asymmetric spread.
    • Enthesitis – inflammation of tendon/tendon attachments; often in Achilles tendon area]
  • Measurement of joint mobility and range of motion of the joint(according to the neutral zero method: range of motion is expressed as the maximum displacement of the joint from the neutral position in angular degrees, where the neutral position is designated as 0°. The starting position is the “neutral position”: the person stands upright with the arms hanging down and relaxed, the thumbs pointing forward and the feet parallel. The adjacent angles are defined as the zero position. Standard is that the value away from the body is given first.)Comparative measurements with the contralateral joint (side comparison) can reveal even small lateral differences.
  • Ophthalmological examination – if conjunctivitis (conjunctivitis) is suspected.
  • Urological examination – if urethritis (inflammation of the urethra) is suspected; balanitis (inflammation of the glans).
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.