Reactive arthritis is non-infectious inflammation of the joints that develops in response to an infectious disease located outside the joint within a few days/weeks. We classify it among the group of spondyloarthritis, therefore also reactive arthritis has common manifestations, which are typical for this group of diseases:
- binding to positivity HLA-B27
- more frequent eye damage (uveitis, conjunctivitis)
- more frequent enthesitis
- skin and mucous membrane damage (aphthae, erythema nodosum,...)
- changes in the axial skeleton are only a late consequence
- increased sedimentation and CRP
Etiology and Pathogenesis[edit | edit source]
Genetic factors play a role (96 % pac. HLA-B27 pozitivních) + infections of the gastrointestinal tract: (salmonella, shigella, yersinie, Campylobacter jejuni), urogenital infection: (Chlamydia trachomatis, Neisseria gonorrhoeae, Ureaplasma urealyticum) and infections of the respiratory system. Sometimes without a previous detectable infection.
The clinical picture[edit | edit source]
General manifestations[edit | edit source]
Twitching, fatigue, temperature.
Musculoskeletal manifestations[edit | edit source]
- Asymmetric mono-/oligoartritis (max. 4 joints) with predilection localization of the supporting joints; affected joints reddish + warmer;
- enthesopathy, which can lead to movement provision interfusion of the tendon insertion on a bone (Achilles tendon, plantar fasciitis)
Cutaneous manifestations[edit | edit source]
UGT symptoms[edit | edit source]
Diagnosis[edit | edit source]
- Oligoarthritis of the supporting joints affecting younger individuals following an infection in UGT / GIT
- lab. higher: unspecified markers of inflammation in the acute phase high (FW, CRP, mucoproteins, ELFO proteins), serology (detection of antibodies against microorganisms), higher. effusion (different from septic arthritis);
- X-ray: mostly negative, sometimes in the chronic phase of the disease sacroiliitis;
- complete Reiter's syndrome: arthritis + urethritis + conjunctivitis (complete triad is rather rare);
- incomplete Reiter's syndrome: arthritis + 1 more symptom; there may also be enthesitis, skin and mucosal ulceration, periostitis .
Differential diagnosis[edit | edit source]
Therapy[edit | edit source]
Individual, based on NSA, for heavier forms glucocorticoids (initial dose 30–50 mg with a gradual decrease; for recurrent joint effusions intra articularly); ATB (for isolating infectious agents / sometimes also with positive serology); basal medicamentations (in chronic course with higher activity; sulfasalazinTemplate:HVLP 2–3 g, MTXTemplate:HVLP 10–20 mg/week).
Prognosis[edit | edit source]
Mostly good, but in a some patients the transition leads to chronicity. (imminent m. Bechtěrev).
Links[edit | edit source]
Related articles[edit | edit source]
References[edit | edit source]
- VOKURKA, Martina – HUGO, Jan. Velký lékařský slovník. 6. edition. 2006. 0 pp. ISBN 80-7345-105-0.
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