Reactive Arthritis

Reactive arthritis (which has sometimes been called Reiter's syndrome) produces pain, swelling, redness and heat in the joints. As its name suggests, this type of arthritis (Read about "Arthritis and Rheumatic Diseases") occurs as a "reaction" to an infection elsewhere in the body. Inflammation is a characteristic reaction of tissues to injury or disease and is marked by swelling, redness, heat and pain. Besides joint inflammation, reactive arthritis is sometimes associated with two other symptoms: redness and inflammation of the eyes (Read about "Conjunctivitis") and inflammation of the urinary tract. (Read about "The Urinary System")

The Arthritis Foundation (AF) says reactive arthritis can develop in certain people following an infection and resulting inflammation in the intestines or genital or urinary tract.

• Genitourinary reactive arthritis - In many patients, reactive arthritis is triggered by a venereal infection in the bladder, the urethra, or, in women, the vagina (the urogenital tract) that is often transmitted through sexual contact. Reactive arthritis has been linked to the sexually transmitted disease Chlamydia. (Read about "STD's")
• Gastrointestinal reactive arthritis - This form of reactive arthritis is caused by an infection in the intestinal tract from eating food or handling substances that are contaminated with bacteria. (Read about "Microorganisms") Reactive arthritis has been linked to infections that cause gastroenteritis or inflammation of the digestive tract (Read about "Gastroenteritis"), particularly Salmonella, campylobacter and shigellosis. (Read about "Salmonella" "Campylobacter" "Shigellosis")

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the arthritis associated with reactive arthritis typically involves pain and swelling in the knees, ankles and feet. Reactive arthritis also can cause spondylitis (inflammation of the vertebrae in the spinal column) or sacroiliitis (inflammation of the joints in the lower back that connect the spine to the pelvis). Approximately half of people with reactive arthritis report low back pain. (Read about "The Spine")

The doctor may use various blood tests (Read about "Laboratory Testing") to help rule out other conditions and confirm a suspected diagnosis of reactive arthritis. Although there is no cure for reactive arthritis, some treatments relieve symptoms of the disorder. These can include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) - NSAIDs reduce joint inflammation and are commonly used to treat patients with reactive arthritis. Some traditional NSAIDs, such as aspirin and ibuprofen, are available without a prescription, but others must be prescribed by a doctor.
• Corticosteroid injections - For people with severe joint inflammation, injections of corticosteroids directly into the affected joint may reduce inflammation. Doctors usually prescribe these injections only after trying unsuccessfully to control arthritis with NSAIDs.
• Topical corticosteroids - These corticosteroids come in a cream or lotion and can be applied directly on the skin lesions, such as ulcers, associated with reactive arthritis. Topical corticosteroids reduce inflammation and promote healing.
• Antibiotics - The doctor may prescribe antibiotics to eliminate the bacterial infection that triggered reactive arthritis. The specific antibiotic prescribed depends on the type of bacterial infection present. It is important to follow instructions about how much medicine to take and for how long; otherwise the infection may persist. (Read about "Antibiotics")

Symptoms of reactive arthritis can resolve in a few months, or the condition may become chronic.