Reactive arthritis

Reactive arthritis, formerly known as Reiter’s syndrome (see note at bottom) is an aseptic asymmetric arthritis which predominantly affects the lower limbs and tends to follow an infection. 

The classical triad is: 

• Arthritis 
• Urethritis 
• Conjunctivitis 

Other possible features include 

• Sacroilitis 
• Keratoderma blenorrhagica 
• Balanitis circinata 
• Aortitis 
• Heart block 

Organisms associated with reactive arthritis include: 

• GI 
• Campylobacter 
• Yersinia 
• Shigella 
• Salmonella 
• c.difficile
• GU 
• Chlamydia 
• Gonorrhoea
• Ureaplasma

Arthritis tends to occur 1 to 3 weeks following infection. 

Reactive arthritis is a spondyloarthrophy. Two-thirds of patients are HLA B27 positive. 

Reactive arthritis is the commonest polyarthritis in young men (males >females)

Treatment: NSAIDs 

Small print: The term Reiter’s syndrome is being phased out due to Dr Reiter’s dubious Nazi past – see reference for more information. 

References:

Barth, W. and Segal, K. Reactive arthritis (Reiter’s syndrome). Am Fam Physician. 1999; 60(2): 499-503. 

Hamdulay, S., Glynne, S. and Keat, A. When is arthritis reactive? Postrgrad Med J. 2006; 82(969): 446-453. 

Panush, R. et al. Retraction of the suggestion to use the term "Reiter's syndrome" sixty-five years later: the legacy of Reiter, a war criminal, should not be eponymic honor but rather condemnation. Arthritis Rheum. 2007; 56(2): 693-694.