Reactive Arthritis

Exam Cram

• Presentation (5): arthritis, uveitis, urethritis, rash on sole of foot and penis

• Mx: nsaids

Outline

Background 

Caused by antibodies attacking own body post infection. Typical infections:

• Chlamydia

• Campylobacter

• Salmonella

Assessment

History:

• Recent STI/ Gastro enteritis

• Arthralgia

• Uveitis

• Urethritis

Examination:

• Kerato blennorrhagica

  • • • Rash on soles of feet

      • Can spread to genitals

• Hot swollen painful joint

  • • • Non irritable

      • Usually able to weight bear, 

      • Minimal effusion

Investigations:

• Nil required

• May require work up as hot swollen joint assessment

  • • • • E.g. joint aspirate- show no growth

        • Seronegative arthropathy (negative antibodies)

Diagnosis

Diagnostic criteria: 

• Clinical- classically post STI/ GE  arthritis, uveitis, urethritis, rash on sole of foot and penis

Differentials

• Septic arthritis, Gonoccocal arthiritis 

• Seronegative arthritis: psoriatic arthritis, ankylosing arthritis and enteric arthritis

• Sero +ve arthritis- e.g. rheumatoid arthritis

Management

1. NSAIDs

2.  Tx underlying cause e.g. chlamydia, if required

References and Resources

Page written in 2024.