Reactive arthritis,
also known as Reiter's syndrome, is a form of arthritis
that occurs as a reaction to infection elsewhere in the
body.
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Overall, men between the ages of 20 and 40 are most
likely to develop reactive arthritis. Men are nine times
more likely than women to develop reactive arthritis due
to venereally acquired infections but women and men are
equally likely to develop reactive arthritis as a result
of food-borne infections. Women with reactive arthritis
typically often have milder symptoms than men.
Reactive arthritis typically begins about one to three
weeks after infection. Symptoms of reactive arthritis
usually last three to 12 months, though in a small
percentage of people the symptoms can return or develop
into a long-term disease. Most people with reactive
arthritis recover fully from the initial flare of
symptoms and are able to return to regular activities 2
to 6 months after the first symptoms appear.
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Reactive arthritis
itself is not contagious but the bacteria that can
trigger reactive arthritis can be passed from person to
person. It is not understood exactly why some people
exposed to reactive arthritis-causing bacteria develop
reactive arthritis and others do not, but scientists
have identified a genetic factor that increases a
person's chance of developing reactive arthritis.
Reactive arthritis is associated with three symptom
groups:
_ Joint inflammation.
_ Redness and inflammation of the eyes (conjunctivitis)
_ Inflammation of the urinary tract (urethritis).
Reactive arthritis often affects the urogenital tract,
including the prostate in men and the vagina in women.
Men may notice an increased need to urinate, a burning
sensation when urinating, and a fluid discharge from the
penis. Some men with reactive arthritis develop
inflammation of the prostate gland.
Women with reactive arthritis may develop problems in
the urogenital tract, such as inflammation of the cervix
or inflammation of the urethra, which can cause a
burning sensation during urination.
The arthritis associated with reactive arthritis
typically involves pain and swelling in the knees,
ankles, and feet. Wrists, fingers, and other joints are
affected less often. People with reactive arthritis
commonly develop tendonitis which results in heel pain
or irritation of the Achilles tendon at the back of the
ankle. Some people with reactive arthritis also develop
heel spurs. Approximately half of people with reactive
arthritis report low-back pain.
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Conjunctivitis
develops in approximately half of people with reactive
arthritis. Conjunctivitis can cause redness of the eyes,
eye pain and irritation, and blurred vision. Eye
involvement typically occurs early in the course of
reactive arthritis.
There is no specific laboratory test to confirm reactive
arthritis so diagnosis can be difficult. During the
diagnostic exam, the doctor will likely take a complete
medical history and note current symptoms as well as any
previous medical problems or infections. The doctor may
use various blood tests to help rule out other
conditions and confirm a suspected diagnosis of reactive
arthritis. The doctor also is likely to perform tests
for infections that might be associated with reactive
arthritis. Doctors sometimes use x rays to help diagnose
reactive arthritis and to rule out other causes of
arthritis.
Although there is no cure for reactive arthritis, some
treatments relieve symptoms of the disorder.
Nonsteroidal anti-inflammatory drugs (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 that are more
effective for reactive arthritis, such as indomethacin
and tolmetin, must be prescribed by a doctor.
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.
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.
A small percentage of patients with reactive arthritis
have severe symptoms that cannot be controlled with any
of the above treatments. For these people, medicine that
suppresses the immune system may be effective.
Several relatively new treatments that suppress tumor
necrosis factor (TNF), a protein involved in the body's
inflammatory response, may be effective for reactive
arthritis. These treatments were first used to treat
rheumatoid arthritis.
As with any ailment, disorder, or disease, good
nutrition is essential. For such an extreme symptom as
arthritis, supplementation is the best way to go.
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