Post-yersinial arthritis in Cleveland, England

Four cases of post-yersinial reactive arthritis are described. All patients presented with an acute lower limb arthropathy with features of an associated enthesopathy. Two patients had restriction of axial skeletal movements. Systemic features were prominent in three, including weight loss and malaise. Mean age of onset was 34 years. Three patients gave a history of antecedent diarrhoea within the previous month. Three patients had raised titres to Y enterocolitica type 0:3 (ranging from 1 in 320 to 1 in 2560) and one had raised titres to Y pseudotuberculosis type 2 at 1 in 640. Two of the three patients with Y enterocolitica reactive arthritis ran a chronic course with low grade arthropathy of lower limbs and back stiffness. One patient developed radiological sacroiliitis at two years, and two patients had an increased sacroiliac index, though x rays of the sacroiliac joints were normal. The patient with Y pseudotuberculosis reactive arthritis had a self limiting disease with spontaneous resolution over six months.