Understanding Reactive Arthritis
What is Reactive Arthritis?
Reactive Arthritis is a type of arthritis that develops in response to a bacterial or viral infection elsewhere in the body. At times, the joint inflammation may be accompanied by red eyes (conjunctivitis) and rash. The immune system reacts aberrantly to the infection in the gastrointestinal, urinary tract infection and attacks the joints, eyes & the skin. The joints hurt & swell as a result of this immune attack.
How is Reactive arthritis different from infective arthritis?
Infective arthritis involves active infection of the joint itself. However, reactive arthritis does not involve infection of the swollen joints. The body reacts to an infection elsewhere in the body in the form of arthritis.
What are the symptoms of reactive arthritis?
Pain and swelling in the joints, especially the knees, ankles are often the first symptoms of reactive arthritis. The joint inflammation usually follows an infection. The infection may be gastrointestinal (diarrhea), genital tract (discharge from the penis), viral illness with sore throat, cough. The joint pain & swelling comes up in a few days or a few weeks after the initial infection episode. At times, this may be accompanied by redness of eyes & a skin rash. The tendons around the joints may be inflamed, most commonly the Achilles tendon resulting in pain and swelling behind the ankle. One can also have low backache due to inflammation of the sacroiliac joints (joints at the base of the spine)
Inflamed achilles tendon in reactive arthritis
Who gets Reactive Arthritis?
Reactive arthritis generally affects persons in the age group of 20 to 50 years. Some people have a genetic predisposition to develop reactive arthritis. If one has the HLA-B27 gene, he/ she has a higher risk of developing reactive arthritis on exposure to these infections.
What lab tests are ordered in reactive arthritis?
There is no single lab test to diagnose Reactive arthritis. Your Rheumatologist will diagnose it based on your history and clinical findings. ESR (Erythrocyte Sedimentation rate- a blood test) may be ordered to document presence of inflammation. Other tests like stool test, throat swab may be done to look for the infection triggering the arthritis. HLA B27 test may be ordered to look for the predisposition to the disease. X rays are generally ordered in chronic form of reactive arthritis to look for joint damage.
How long does Reactive arthritis last?
Unlike Rheumatoid arthritis, Reactive arthritis is usually a short lived condition. It generally lasts for upto 6 months. A small number of people may go on to develop chronic arthritis lasting for more than 6 months. A few of the patients, especially those with HLA-B 27 gene may have recurrent episodes of reactive arthritis.
How is Reactive arthritis treated?
You will be given an antibiotic if you are found to have active infection that triggered the arthritis. Non steroidal anti inflammatory drugs (NSAIDs) will be given to reduce the joint inflammation. A short course of steroids/ steroid injection may be given in a joint depending on the severity of the joint inflammation. Disease modifying medications like Sulphasalazine/ methotrexate are given depending on the severity of joint inflammation. Your Rheumatologist will prescribe these medications based on the severity of your arthritis.