Reactive Arthritis (Reiter’s Syndrome)

What is reactive
arthritis?

Reactive arthritis is a type of arthritis that occurs because of an infection.
Arthritis is when joints become inflamed and painful. Reactive arthritis is not
contagious. It was formerly known as Reiter’s syndrome. It affects men more often than
women. It develops most often between ages 20 and 50.

What causes reactive
arthritis?

Reactive arthritis is not contagious, but it’s caused by some infections that are
contagious. The infections that most often cause the disease are spread through sexual
contact. The bacteria Chlamydia trachomatis. It can cause infections in the bladder,
urethra, penis, or vagina.

Other
infections that can cause reactive arthritis infect the gut. One cause is salmonella.
This infection can come from eating food or handling objects that have the bacteria.

Reactive arthritis may also be linked to genes. People with reactive arthritis often
have the HLA-B27 gene. But many people have this gene without getting reactive
arthritis.

Who is at risk for reactive
arthritis?

Risk
factors for getting reactive arthritis include:

  • Having
    an infection from sexual contact
  • Having
    an illness from contaminated food
  • Being
    male

What are the symptoms of reactive
arthritis?

Reactive arthritis may cause arthritis symptoms, such as joint pain and inflammation.
It can also cause urinary tract symptoms and eye infection (conjunctivitis). Symptoms
can last from 3 to 12 months. In a small number of people, the symptoms may turn into
chronic disease. Symptoms can happen a bit differently in each person, and may
include:

Arthritis symptoms

  • Joint pain and inflammation that often
    affect the knees, feet, and ankles
  • Inflammation of a tendon that is attached to
    bone. This may cause heel pain or shortening and thickening of the
    fingers.
  • Bony growths in the heel (heel spurs) that
    can cause chronic pain
  • Inflammation of the spine (spondylitis)
  • Inflammation of the lower back joints
    (sacroiliitis)

Urinary tract symptoms

Men:

  • Increased urine
  • Burning sensation during urination
  • Discharge from penis
  • Inflamed prostate gland (prostatitis)

Women:

  • Inflamed cervix
  • Inflamed urethra. This causes a burning
    sensation during urination.
  • Inflamed fallopian tubes (salpingitis)
  • Inflamed vulva and vagina
    (vulvovaginitis)

Eye symptoms

  • Red eyes
  • Painful and irritated eyes
  • Blurry vision
  • Inflamed mucous membrane that covers the
    eyeball and eyelid (conjunctivitis)
  • Inflammation of the inner eye (uveitis)

The symptoms of reactive arthritis can
be like other health conditions. Make sure to see your healthcare provider for a
diagnosis.

How is reactive arthritis
diagnosed?

The
process starts with a health history and a physical exam. Diagnosis can be difficult.
This is because there are no specific tests that can confirm the condition. Some blood
tests may be done to rule out other conditions, such as rheumatoid arthritis and lupus.
Other tests may include:

  • Erythrocyte
    sedimentation rate (ESR or sed rate).
     This test looks at how quickly red
    blood cells fall to the bottom of a test tube. When swelling and inflammation are
    present, the blood’s proteins clump together and become heavier than normal. They
    fall and settle faster at the bottom of the test tube. The faster the blood cells
    fall, the more severe the inflammation.
  • Tests for
    infections.
     This includes a test for chlamydia. It may also include tests for
    other infections that are linked to reactive arthritis.
  • Joint
    aspiration (arthrocentesis).
     A small sample of the synovial fluid is taken
    from a joint. It’s tested to see if crystals, bacteria, or viruses are present.
  • Urine and
    stool samples.
     These are used to look for bacteria or other signs of
    disease.
  • X-rays. This test uses a small amount of radiation to create images of tissues,
    bones, and organs. X-rays are used to look for swelling or damage to the joint. This
    can check for signs of spondylitis or sacroiliitis.
  • Gene
    testing.
     A test may be done to check for HLA-B27.

You may also have testing to rule out other forms of arthritis.