• sterile inflammation of joints triggered by infection in another part of the body

• trigger:

  • gastrointestinal

  • urogenital infection

    • sexually acquired

      • sexually acquired reactive arthritis SARA

        • Chlamydia trachomatis = most common

        • 10x more frequent in men compared to women

        • HLA-B27 increases susceptibility to sexually acquired reactive arthritis by up to 50 times

• 2-4w after triggering infection

• other symptoms:

  • Uretrhitis

  • conjunctivitis

  • uveitis

  • skin manifestations

    • keratoderma blennorrhagica

  • Circinate balanitis/vulvitis

    • shallow painless ulcers

    • common manifestation of reactive arthritis

  • mouth ulcers

  • cardiac,renal or neurological involvement

Reiter’s syndrome

• triad

  • arthritis

  • urethritis

  • conjunctivitis

Diagnosis

• recognition of typical constellation of symptoms

• demonstration of ecidence of genitourinary infection

• investigation of specificity and activity of arthritis

  • ANA

  • RF/anti-CCP

Treatment

• Rest and NSAID

• Antimicrobial therapy for any ID orgasim

• Variety of treatments for arthritis

  • rest

  • NSAID

  • intra-articular corticosteroid

  • systemic sorticosteroid

  • DMARDs

• usually resolves spontaneously within 3-12 months

• course = variable

• 15-20% patients develop disabling complications

  • chronic arthritis

  • eye imflammation