Reactive Arthritis: Causes, Risk Factors, Investigations, Treatment, Prevention

Reactive Arthritis is a medical condition where infections present in other regions of the body lead to joint swelling and pain; this is known as Reactive Arthritis. This is quite a rare condition. The infection causing this condition can be anywhere; however, it commonly occurs in urinary tract system, intestines and genitalia. Reactive arthritis often affects the knees, ankles joints and feet. Patients can also suffer from inflammation of the skin, eyes, and urethra. Sometimes the term Reactive Arthritis is used synonymously with Reiter’s syndrome; however, Reiter’s syndrome is in fact a specific form of reactive arthritis where the eyes, joints and urethra get inflamed. Many patients experience the symptoms of reactive arthritis at on and off basis and symptoms gradually subside within a year.

Treatment comprises of medications, such as antibiotics for treating the infection; and for symptom relief, medications like NSAIDs, corticosteroid injections and medicines to treat rheumatoid arthritis etc. are given.

As mentioned earlier, reactive arthritis is a medical condition which occurs in response to an infection occurring in some other part of the body. Reactive arthritis causes swelling and pain in the joints as a reaction to some other infection in the body. Reactive arthritis in itself is not contagious, but the causative bacteria can be transmitted either through eating contaminated food or is transmitted sexually. Not all of the individuals affected by these bacteria end up with reactive arthritis.

• Salmonella
• Chlamydia
• Yersinia
• Campylobacter
• Shigella

• Individuals aged between 20 and 40 years of age are more susceptible to develop reactive arthritis.
• Men are at a higher risk for developing reactive arthritis, as a result of exposure to sexually transmitted bacteria.
• Hereditary factors are also thought to play a role.

• Physical exam is done where your physician will check your joints for any indications of inflammation, like warmth, tenderness and swelling. The spine and the diseased joints are examined for range of movement. The eyes and skin are also examined for inflammation and rashes respectively.
• Blood tests are done to check for signs of previous or current infections, inflammation, antibodies and genetic marker connected to reactive arthritis.
• Joint fluid tests are done, where the fluid is withdrawn from the affected joint using a needle. This fluid sample is tested for WBCs, bacteria (septic arthritis), uric acid crystals (gout).
• X-rays are taken of the lower back, joints and pelvis to check for any typical signs of reactive arthritis and to exclude other forms of arthritis.

The aim of treatment is managing the symptoms and treating the underlying infections, if present. Medications such as antibiotics are given for treating bacterial infection. The type of antibiotic given depends on the causative bacteria. Physical therapy exercises benefit by improving the joint function, reducing the stiffness, improving range of motion, strengthening the muscles and increasing flexibility.

• NSAIDs or nonsteroidal anti-inflammatory drugs, such as naproxen, indomethacin, ibuprofen help with the pain and swelling of reactive arthritis.
• Corticosteroid injections can be given into the affected joints to help alleviate pain and inflammation.
• Drugs used for rheumatoid arthritis, such as sulfasalazine, methotrexate etc. benefit in relieving stiffness and pain.

If you have carry a risk of developing reactive arthritis due to hereditary factors, then there is not much you can do about it. However, you can take precautions to reduce your exposure to bacteria which cause reactive arthritis. You can avoid this by cooking your food thoroughly and storing your food at proper temperatures to avoid food borne bacteria, such as shigella, salmonella, campylobacter and yersinia. Using condoms decreases the risk of contracting infections which can be transmitted sexually.