Reactive arthritis: Difference between revisions
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** Chlamydia trachomatis |
** Chlamydia trachomatis |
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== Clinical |
== Clinical Manifestations == |
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* Classic triad of arthritis, urethritis, and conjunctivitis only seen in about a third of patients |
* Classic triad of arthritis, urethritis, and conjunctivitis only seen in about a third of patients |
Revision as of 22:56, 14 July 2020
Definition
- A syndrome cause by specific infections in a genetically susceptible host that is characterized by conjunctivitis, urethritis, and seronegative arthritis
Associated Infections
- Enteric infections
- Shigella spp.
- Salmonella spp.
- Yersinia enterocolitica and Y. pseudotuberculosis
- Campylobacter jejuni
- Genitourinary infections
- Chlamydia trachomatis
Clinical Manifestations
- Classic triad of arthritis, urethritis, and conjunctivitis only seen in about a third of patients
- Onset 1-4 weeks after infection
- May present with constitutional symptoms (fever, malaise, weight loss)
- Arthritis is usually peripheral and axial, symmetric and additive evolving over 1-2 weeks
- Can have dactylitis, enthesistis, tendinitis, and fasciitis
- Oral ulcers are common but often asymptomatic
- Keratoderma blennorhagica, a palmoplantar pustular disease
- Circinate balanitis, painless erosions from ruptured vesicles on the glans
Investigations
- ESR/CRP and acute-phase reactants
- CBC may show mild anemia
- Synovial fluid non-specific inflammation
- X-rays can show justaarticular osteoporosis
- Later findings include marginal erosions, loss of joint space, periostitis, reactive born formation, and plantar spurs
Management
- NSAIDs for symptom relief, though often not helpful
- Indomethacin 75-150mg/d in divided doses
Prognosis
- Symptoms typically resolve over 3-5 months
- Can be chronic (about 15%)