Information From Your Health Care Provider

REACTIVE ARTHRITIS

(Reiter's Syndrome)

Basic information

description

Reactive arthritis (sometimes called Reiter's syndrome) is an inflammatory disorder. The inflammation can affect the joints, urinary tract, eyes, or skin. Reactive arthritis typically develops after an intestinal, genital, or urinary tract infection. It affects men (usually young) more than women, and it is rare in children.

FREQUENT SIGNS & SYMPTOMS

Painful, swollen joints, especially in the knees, ankles, feet, and wrists. Heel pain may occur.
Toes and fingers may be swollen (look like sausages).
Pain in lower back and buttocks.
Pain or discomfort when urinating.
Discharge from the penis or the vagina.
Increased urination.
Red, itchy, burning, and tearing of the eyes.
Skin rash similar to psoriasis on the soles, palms, and around fingernails and toenails.
Mouth sores.
Diarrhea may occur before other symptoms.
General ill feeling or headache.

causes

The exact cause is unclear. It is a reaction to an infection elsewhere in the body. The original infection may be mild and may have occurred several weeks before. It can be a sexually transmitted infection or a gastrointestinal infection. There are several types of bacteria that can be involved in the infection (e.g., Chlamydia, Salmonella, Shigella, Yersinia or Campylobacter). A genetic factor is also involved in most cases.

risk increases with

Males more than females.
Genetic factors.

PREVENTIVE MEASURES

None specific.
Practice safe sex to avoid sexually transmitted diseases.
Take proper precautions to avoid food-borne bacteria infections.

expected outcomes

Reactive arthritis may continue for 3 to 12 months. Symptoms may range from mild to severe and they may come and go. Treatment helps relieve symptoms. A number of patients have recurrences over the years.

possible complications

Chronic or recurrent symptoms that lead to disability.
Eye complications.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms and activities. Medical tests may include blood and genetic studies. An x-ray may be done in some cases. There is no specific test that can diagnose the disorder.
There is no treatment that cures reactive arthritis. Symptoms are managed with drug therapy and physical therapy.
Treatment may be needed for eye symptoms to prevent complications.

medications

Your health care provider may prescribe:
- Nonsteroidal anti-inflammatory drugs for arthritis symptoms.
- Antibiotics, such as tetracyclines, for urethritis.
- Corticosteroid injections for painful joints.
- Corticosteroid eyedrops for severe eye symptoms.
- Topical corticosteroid drugs for skin symptoms.
- Drugs that suppress the immune system (rare).
- Drugs called tumor-necrosis factor inhibitors that are used for other forms of arthritis.

activity

Physical therapy is often recommended to help maintain range of motion of the joints.
After inflammation improves, exercise the affected joints daily with stretching and strengthening routines. Follow medical instructions. Maintain good posture.
To relieve foot pain, wear cushion pads and arch supports in your shoes.