2Reactive arthritis or post-infectious arthritis?
Section snippets
Clinical features
The typical clinical picture of reactive arthritis (ReA) is characterized by asymmetrical oligoarthritis, often in large joints of the lower extremities. Patients can also have arthritis in the upper limbs. Moreover, a mild polyarticular form has been described, particularly in the small joints.1, 2
In addition to arthritis, patients with ReA can have bursitis or enthesitis, which can also exist as the only musculoskeletal manifestation. Other extra-articular features include inflammatory low
When should antibiotic treatment be given in ReA?
It is important to discuss the role of antibiotic therapy both with respect to treatment of infection and treatment of arthritis. In practice, the issue is whether short-term or long-term treatment is warranted.
Outcome and prognosis of ReA
The duration of acute ReA usually varies between 3 and 5 months.64 The long-term prognosis of enteroarthritides is best known for Yersinia- and Shigella-triggered ReA. Mild peripheral arthralgia and low back pain are frequent in patients with previous ReA (Table 2). About 15% of patients develop AS and about 30% develop radiological sacroiliitis.65, 66 It is still not known whether ReA contributes to the development of sacroiliitis or AS, or whether sacroiliac changes would have occurred in a
Summary
ReA can be regarded as a form of post-infectious arthritis in which microbial structures have been detected in the inflamed joints. While ReA is a sequel of infection (usually in the gastrointestinal or the urogenital tract), the role of antibiotic therapy to prevent the triggering of arthritis or to prevent the development of chronic sequels has not been determined. In the case of established ReA, prolonged treatment of Chlamydia-induced ReA may be of benefit, but in other forms of ReA, there
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Post-Infectious Arthritis and Reactive Arthritis
2024, Infection and AutoimmunityNeisseria meningitidis as a cause of isolated bilateral polyarticular native knee joint septic arthritis
2021, Clinical Infection in PracticeCitation Excerpt :In our patient the timeline of events is an important factor when differentiating Reactive from Septic arthritis. It has been reported that patients with Septic arthritis typically have symptoms for less than two weeks at presentation, with the characteristic features of hot, swollen, painful and restricted joints (Mathews et al., 2007) whereas a Reactive arthritis presents two to four weeks after the preceding infection (Hannu et al., 2006). Our patient suffered from a sore throat, presumed streptococcal in origin, five days prior to her oligoarticular symptoms which led to admission.
Other spondyloarthritis forms
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2019, Best Practice and Research: Clinical RheumatologyCitation Excerpt :There is an unresolved issue regarding the precise role played by the triggering bacteria in the development of ReA. By definition, no viable bacteria can be cultivated from the inflamed joint, and the triggering enterobacteria have generally been eliminated from the gut at the time of disease outburst [6]. However, in the case of Chlamydia-induced ReA, there is evidence for the persistence of bacteria within monocytic cells in the synovium [8].
Leaky gut, circulating immune complexes, arthralgia, and arthritis in IBD: coincidence or inevitability?
2024, Frontiers in ImmunologyImmunologic derangement caused by intestinal dysbiosis and stress is the intrinsic basis of reactive arthritis
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