REACTIVE ARTHRITIS

SUMMARY

1. The most common cause of acute, non-traumatic arthritis in < 50 yrs is reactive arthritis, which is an immunologic reaction to an infection elsewhere in the body.

2. Typically GU/GI infections. GU infection from Chlamydia trachomatis and GI infections due to Salmonella, Shigella, Yersinia, Campylobacter, and C.Diff.

3. The arthritis develops within 2 months of the infection, but the organism is not identified.

4. Commonly presents as an asymmetric, mono- or oligoarticular arthritis of the lower limbs.

5. Enthesitis is common and characteristic - insertion points of the Achilles tendon and the plantar fascia.

6. Extra-articular manifestations - keratodenna blennorrhagicum, mucocutaneous genital lesions, mouth ulcers, conjunctivitis, and iritis.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].