Reiter's syndrome, sometimes referred to as Reiters Disease or Rider's type of arthritis, is a form of arthritis that occurs as a reaction to infection elsewhere in the body.

In some patients, Reiters disease is triggered by a venereal infection that is often transmitted through sexual contact. People may also become infected with Reiters disease-causing bacteria from eating or handling improperly prepared food, such as meats that are not stored at the proper temperature.

Overall, men between the ages of 20 and 40 are most likely to develop Reiter's syndrome. Men are nine times more likely than women to develop Reiters syndrome due to venereally acquired infections but women and men are equally likely to develop Reiters syndrome as a result of food-borne infections. Women with Reiters syndrome typically often have milder symptoms than men.

Reiters syndrome (Rider's type of arthritis) typically begins about one to three weeks after infection. Symptoms of Reiters syndrome 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 Reiter's syndrome 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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Reiters syndrome itself is not contagious but the bacteria that can trigger Reiters syndrome can be passed from person to person. It is not understood exactly why some people exposed to Reiters syndrome-causing bacteria develop Reiters syndrome and others do not, but scientists have identified a genetic factor that increases a person's chance of developing Reiters syndrome.

Reiters disease is associated with three symptom groups:

• Joint inflammation

• Redness and inflammation of the eyes (conjunctivitis)

• Inflammation of the urinary tract.

Reiters syndrome 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 Reiter's syndrome develop inflammation of the prostate gland.

Women with Reiters syndrome 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 Reiters syndrome typically involves pain and swelling in the knees, ankles, and feet. Wrists, fingers, and other joints are affected less often. People with Reiter's syndrome commonly develop tendonitis which results in heel pain or irritation of the Achilles tendon at the back of the ankle. Some people with Reiters syndrome also develop heel spurs. Approximately half of people with Reiter's syndrome report low-back pain. Reiters syndrome also can cause spondylitis or sacroiliitis.

Conjunctivitis develops in approximately half of people with Reiter's syndrome. Conjunctivitis can cause redness of the eyes, eye pain and irritation, and blurred vision. Eye involvement typically occurs early in the course of Reiter's syndrome.

There is no specific laboratory test to confirm Reiters syndrome 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 Reiters syndrome. The doctor also is likely to perform tests for infections that might be associated with Reiters syndrome. Doctors sometimes use x-rays to help diagnose Reiter's syndrome and to rule out other causes of arthritis.

Although there is no cure for Reiters syndrome, some treatments relieve symptoms of the disorder.

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce joint inflammation and are commonly used to treat patients with Reiters syndrome.

The doctor may prescribe antibiotics to eliminate the bacterial infection that triggered Reiters syndrome. The specific antibiotic prescribed depends on the type of bacterial infection present.

A small percentage of patients with Reiters syndrome 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.

 

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