Understanding Reactive Arthritis: Causes, Symptoms, Diagnosis, and Treatment

Reactive arthritis is a type of arthritis that affects the joints, eyes, urethra (the tube that carries urine from the bladder out of the body), and skin. It can cause sudden and severe symptoms or develop more gradually, with periods of remission and recurrence. If you or someone you know has been diagnosed with reactive arthritis, it's essential to understand the causes, symptoms, diagnosis, and treatment options available.

What Causes Reactive Arthritis?

The exact cause of reactive arthritis is unknown, but researchers believe that a combination of genetic and environmental factors may play a role. About 75% of people with reactive arthritis have a positive blood test for the genetic marker HLA-B27. In many cases, the condition develops following an infection, such as:

• Chlamydia trachomatis or Ureaplasma urealyticum (sexually transmitted infections)

• Shigella, Salmonella, Yersinia, or Campylobacter bacteria (intestinal infections)

While there is no known way to prevent reactive arthritis, practicing safe sex and maintaining good hygiene can help reduce your risk of developing the condition.

Symptoms of Reactive Arthritis

The symptoms of reactive arthritis can vary from person to person and may not appear at the same time. Some common symptoms include:

• Painful urination and discharge from the penis (if the urethra is inflamed)

• Diarrhea (if the intestines are affected)

• Joint pain and swelling, typically in the fingers, toes, ankles, hips, and knees

• Mouth ulcers

• Eye inflammation

• Scaly skin patches (keratoderma blennorrhagica) on the palms, soles, trunk, or scalp

• Back pain from sacroiliac (SI) joint involvement

• Pain from inflammation of the ligaments and tendons (enthesitis)

Diagnosing Reactive Arthritis

Diagnosing reactive arthritis can be challenging because symptoms may occur weeks apart. A doctor may diagnose the condition when a patient's arthritis occurs together with or shortly after inflammation of the eye and urinary tract, lasting for a month or longer. While there is no specific test for reactive arthritis, doctors may perform the following:

• Check urethral discharge for sexually transmitted infections

• Test stool samples for signs of infection

• Conduct blood tests to check for the HLA-B27 genetic marker, elevated white blood cell count, and increased erythrocyte sedimentation rate (ESR)

• Take X-rays of the joints, back, and pelvis to assess for abnormalities or damage

Treatment Options for Reactive Arthritis

Treatment for reactive arthritis depends on the specific symptoms and their severity. Some common treatment options include:

• Antibiotics to treat bacterial infections like chlamydia

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce joint inflammation

• Steroids to treat skin eruptions and eye inflammation

• Methotrexate or other medications for chronic cases

• Physical therapy and regular exercise to maintain joint mobility and strength

The outlook for people with reactive arthritis varies. While most people recover within three to four months, about half experience recurrences over several years. Some may develop complications, such as heart muscle inflammation, spine stiffening, glaucoma, progressive blindness, foot abnormalities, or fluid accumulation in the lungs. Working closely with your healthcare team and following your treatment plan can help manage your symptoms and improve your quality of life.

For more information on reactive arthritis, visit:

• Arthritis Foundation - Reactive Arthritis

• American College of Rheumatology - Reactive Arthritis

• National Institute of Arthritis and Musculoskeletal and Skin Diseases - Reactive Arthritis

The Bottom Line

Early aggressive treatment within the first few weeks significantly improves outcomes and reduces the risk of chronic joint damage. Prompt antibiotic therapy to eliminate the triggering infection is crucial, even if the original infection seemed to clear on its own. If you're experiencing joint pain and eye irritation following a recent infection, Doctronic can help determine if this constellation of symptoms warrants immediate evaluation.