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When is arthritis reactive?
S S Hamdulay1, S J Glynne, A Keat
1Department of Rheumatology, Northwick Park Hospital, Harrow, Middlesex, UK. hamdu@hotmail.com
Postgraduate Medical Journal
|July 11, 2006
Summary
Reactive arthritis, a spondyloarthropathy, affects young adults, often triggered by infection. Diagnosis requires linking symptoms to a specific trigger infection, with HLA-B27 gene presence noted.
Area of Science:
- Rheumatology
- Immunology
- Infectious Diseases
Background:
- Reactive arthritis is a key cause of lower limb oligoarthritis in young adults.
- It belongs to the spondyloarthropathy family, characterized by distinct lesion distribution and extra-articular manifestations.
- Confusion exists due to varied terminology for this inflammatory arthritis.
Purpose of the Study:
- To review the clinical features, investigation, diagnosis, and management of reactive arthritis.
- To discuss sexually acquired and enteric forms of reactive arthritis.
- To explore potential links with HIV infection.
Main Methods:
- Review of clinical features, diagnostic approaches, and management strategies.
- Consideration of specific forms (sexually acquired, enteric) and associated infections.
- Discussion of genetic factors, including HLA-B27, and potential links with HIV.
Main Results:
- Reactive arthritis is triggered by distant infections, with genetic susceptibility linked to HLA-B27.
- Diagnosis involves a two-stage process confirming a temporal link to a recognized trigger infection.
- Clinical presentation, investigation, and management protocols are detailed.
Conclusions:
- Understanding the trigger infections and genetic factors is crucial for diagnosing and managing reactive arthritis.
- Specific management strategies for sexually acquired and enteric forms are essential.
- Further research into the uncertain mechanisms and HIV links is warranted.
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