Reactive Arthritis

Reactive Arthritis - What it is

SGH Rheumatology and Immunology Department sees patients with Reactive Arthritis. It is a type of inflammatory arthritis that occurs in response to an infection, most commonly involving the gastrointestinal or genitourinary systems. The condition is called "reactive" because it is believed to be a reaction of the immune system to the infection.

Interestingly, Reactive Arthritis may also occur during or after viral infections which cause coughs and sore throat. It has been noted that COVID-19 can cause Reactive Arthritis or reveal an underlying Rheumatological disease that you already had but has been dormant.

Reactive Arthritis - Symptoms

The symptoms of reactive arthritis usually develop within 1 to 4 weeks after an infection. The most common symptoms are:

joint pain
stiffness
swelling, especially in the lower limbs, such as the knees, ankles, and feet.
The affected joints may also be warm to the touch and may feel tender or painful to move.

In addition to joint symptoms, reactive arthritis can also cause inflammation in other parts of the body, such as the eyes, skin, and genitals. Eye inflammation (uveitis) can cause redness, pain, and sensitivity to light, while skin rashes may appear on the palms and soles of the feet. Genital symptoms can include discharge, pain, and ulcers.

Reactive Arthritis - How to prevent?

Reactive Arthritis - Causes and Risk Factors

Reactive arthritis is typically triggered by an infection, usually bacterial, that affects the gastrointestinal or genitourinary system. The bacteria associated with reactive arthritis include Salmonella, Shigella, Yersinia, and Campylobacter, which can be transmitted through contaminated food or water.

Reactive Arthritis may also occur in reaction to viral infections.

The exact mechanism of how the infection leads to reactive arthritis is not fully understood. It is believed that the bacteria trigger an abnormal immune response in genetically susceptible individuals. This immune response can lead to inflammation in the joints and other parts of the body.

Some factors that increase the risk of developing reactive arthritis include:

Having a genetic predisposition
Being male
Age: most commonly affects people between the ages of 20 and 40
Recent gastrointestinal or genitourinary infection
Presence of HLA-B27 gene

Reactive Arthritis - Diagnosis

Diagnosis of reactive arthritis is based on the presence of symptoms, medical history, and physical examination. Blood tests can be used to check for markers of inflammation and HLA-B27 gene. Imaging tests, such as X-rays, CT scans, or MRI, may also be used to evaluate joint damage.

Reactive Arthritis - Treatments

The treatment of reactive arthritis focuses on relieving symptoms and treating the underlying infection. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can be used to relieve joint pain and inflammation. In severe cases, disease-modifying antirheumatic drugs (DMARDs), such as sulfasalazine or methotrexate, may be used to slow joint damage.

Physiotherapy and exercise can also help to relieve symptoms and maintain joint mobility. In addition, the management of any underlying infection is important to prevent recurrent episodes of reactive arthritis.

Prognosis for Reactive Arthritis

The prognosis for reactive arthritis is generally good, with most people recovering within a few months to a year. However, in some cases, joint damage can be permanent. Early diagnosis and treatment can help to prevent long-term joint damage and complications.

As such, it is very important to seek medical attention and/or visit SGH RHI for assessment.