Reactive arthritis - Revision history

Meganguy: /* Clinical Features */

2021-08-13T00:31:06Z

Clinical Features

← Older revision		Revision as of 00:31, 13 August 2021
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	**[[Urethritis]]: generally caused by Chlamydia or Ureaplasma		**[[Urethritis]]: generally caused by Chlamydia or Ureaplasma
	**Enteritis: generally caused by Salmonella or Shigella		**Enteritis: generally caused by Salmonella or Shigella
			**Respiratory tract infections, both bacterial and viral (case reports have been written about COVID-19 associated reactive arthritis)
	**Preceding infection may be clinically silent		**Preceding infection may be clinically silent
	*Musculoskeletal symptoms		*Musculoskeletal symptoms

Elcatracho: /* Background */

2021-02-10T14:30:01Z

Background

← Older revision		Revision as of 14:30, 10 February 2021
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	*Historically also known as "Reiter syndrome"		*Historically also known as "Reiter syndrome"
	*Seronegative spondyloarthropathy that manifests as an acute, asymmetric, oligoarthritis (LE>UE) that occurs 2-6 weeks after infection		*Seronegative spondyloarthropathy that manifests as an acute, asymmetric, oligoarthritis (LE>UE) that occurs 2-6 weeks after infection
			*Patients often positive for HLA-B27
	*Associated with bacterial infections		*Associated with bacterial infections
	**[[Shigella]], [[Salmonella]], [[Campylobacter]], [[Chlamydia]], etc.		**[[Shigella]], [[Salmonella]], [[Campylobacter]], [[Chlamydia]], etc.

ClaireLewis at 23:51, 17 October 2019

2019-10-17T23:51:59Z

← Older revision		Revision as of 23:51, 17 October 2019
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	==Evaluation==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
	*Must exclude [[Gonococcal ~~septic~~ arthritis\|gonococcal arthritis]] and other mimics		*Must exclude [[Gonococcal arthritis\|gonococcal arthritis]] and other mimics

	==Management==		==Management==

ClaireLewis at 16:01, 29 August 2019

2019-08-29T16:01:36Z

← Older revision		Revision as of 16:01, 29 August 2019
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	==Background==		==Background==
			*Historically also known as "Reiter syndrome"
	*Seronegative spondyloarthropathy that manifests as an acute, asymmetric, oligoarthritis (LE>UE) that occurs 2-6 weeks after infection		*Seronegative spondyloarthropathy that manifests as an acute, asymmetric, oligoarthritis (LE>UE) that occurs 2-6 weeks after infection
	*Associated with bacterial infections		*Associated with bacterial infections
	**Shigella, Salmonella, Campylobacter, Chlamydia, etc.		**[[Shigella]], [[Salmonella]], [[Campylobacter]], [[Chlamydia]], etc.
	*Classic triad: urethritis, conjunctivitis, and arthritis ("Can't pee, can't see, can't climb a tree")		*Classic triad: [[urethritis]], [[conjunctivitis]], and [[arthritis]] ("Can't pee, can't see, can't climb a tree")

	==Clinical Features==		==Clinical Features==
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	**[[Dactylitis]] (sausage digits)		**[[Dactylitis]] (sausage digits)
	**[[Low back pain]]		**[[Low back pain]]
	*~~Extraarticular~~ symptoms		*Extra-articular symptoms
	**[[Conjunctivitis]] (less frequently [[uveitis]], [[keratitis]])		**[[Conjunctivitis]] (less frequently [[uveitis]], [[keratitis]])
	**GU symptoms		**GU symptoms
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	*Symptomatic treatment of arthritis		*Symptomatic treatment of arthritis
	**[[NSAIDs]] are first line ([[naproxen]], [[diclofenac]], [[indomethacin]])		**[[NSAIDs]] are first line ([[naproxen]], [[diclofenac]], [[indomethacin]])
	**Intraarticular and systemic steroids for NSAID refractory		**Intraarticular and systemic [[steroids]] for NSAID refractory

	==Disposition==		==Disposition==

Mholtz at 03:05, 30 December 2016

2016-12-30T03:05:55Z

← Older revision		Revision as of 03:05, 30 December 2016
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	==Background==		==Background==
			*Seronegative spondyloarthropathy that manifests as an acute, asymmetric, oligoarthritis (LE>UE) that occurs 2-6 weeks after infection
	*Associated with bacterial infections		*Associated with bacterial infections
	**Shigella, Salmonella, Campylobacter, Chlamydia, etc.		**Shigella, Salmonella, Campylobacter, Chlamydia, etc.
			*Classic triad: urethritis, conjunctivitis, and arthritis ("Can't pee, can't see, can't climb a tree")

	==Clinical Features==		==Clinical Features==
	*~~Can't see~~, ~~Can't pee, Can't climb a tree~~		*Preceding Infection
	**(~~Classical triad in 1/3 of patients~~)		**[[Urethritis]]: generally caused by Chlamydia or Ureaplasma
	**Conjunctivitis or uveitis		**Enteritis: generally caused by Salmonella or Shigella
	**~~Nongonococcal urethritis~~		**Preceding infection may be clinically silent
	**~~Asymmetric oligoarthritis~~		*Musculoskeletal symptoms
			**[[Arthritis]]: oligoarthritis, usually in the lower extremities
			**Enthesitis (pain at insertion sites)
			**[[Dactylitis]] (sausage digits)
			**[[Low back pain]]
			*Extraarticular symptoms
			**[[Conjunctivitis]] (less frequently [[uveitis]], [[keratitis]])
			**GU symptoms
			**Oral lesions
			**Cutaneous and nail changes
	*Keratoderma blennorrhagicum<ref>Wolff K, Johnson R, Saavedra AP. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In: Wolff K, Johnson R, Saavedra AP. eds. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e. New York, NY: McGraw-Hill; 2013.</ref>		*Keratoderma blennorrhagicum<ref>Wolff K, Johnson R, Saavedra AP. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In: Wolff K, Johnson R, Saavedra AP. eds. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e. New York, NY: McGraw-Hill; 2013.</ref>
	**Develops in 15% of patients		**Develops in 15% of patients
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	{{Differencial Diagnosis Migratory Arthritis}}		{{Differencial Diagnosis Migratory Arthritis}}

	==Evaluation==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
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	==Management==		==Management==
	*NSAIDs		*Treat inciting infection
	*~~Antibiotics not needed~~ for ~~postdysentery form~~		*Symptomatic treatment of arthritis
	*Consider doxycycline in chlamydia		**[[NSAIDs]] are first line ([[naproxen]], [[diclofenac]], [[indomethacin]])
			**Intraarticular and systemic steroids for NSAID refractory

	==Disposition==		==Disposition==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T23:39:18Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

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	{{Differencial Diagnosis Migratory Arthritis}}		{{Differencial Diagnosis Migratory Arthritis}}
	==~~Diagnosis~~==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
	*Must exclude [[Gonococcal septic arthritis\|gonococcal arthritis]] and other mimics		*Must exclude [[Gonococcal septic arthritis\|gonococcal arthritis]] and other mimics

Ostermayer: Text replacement - " pts" to " patients"

2016-06-21T16:50:18Z

Text replacement - " pts" to " patients"

← Older revision		Revision as of 16:50, 21 June 2016
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	==Clinical Features==		==Clinical Features==
	*Can't see, Can't pee, Can't climb a tree		*Can't see, Can't pee, Can't climb a tree
	**(Classical triad in 1/3 of ~~pts~~)		**(Classical triad in 1/3 of patients)
	**Conjunctivitis or uveitis		**Conjunctivitis or uveitis
	**Nongonococcal urethritis		**Nongonococcal urethritis
	**Asymmetric oligoarthritis		**Asymmetric oligoarthritis
	*Keratoderma blennorrhagicum<ref>Wolff K, Johnson R, Saavedra AP. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In: Wolff K, Johnson R, Saavedra AP. eds. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e. New York, NY: McGraw-Hill; 2013.</ref>		*Keratoderma blennorrhagicum<ref>Wolff K, Johnson R, Saavedra AP. The Skin in Immune, Autoimmune, and Rheumatic Disorders. In: Wolff K, Johnson R, Saavedra AP. eds. Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 7e. New York, NY: McGraw-Hill; 2013.</ref>
	**Develops in 15% of ~~pts~~		**Develops in 15% of patients
	**Found on palm/soles. Vesicles/pustules with yellow/brown color. Appears similar to pustular [[psoriasis]]		**Found on palm/soles. Vesicles/pustules with yellow/brown color. Appears similar to pustular [[psoriasis]]

Ostermayer: Text replacement - "Category:Rheum" to "Category:Rheumatology"

2016-03-22T16:17:04Z

Text replacement - "Category:Rheum" to "Category:Rheumatology"

← Older revision		Revision as of 16:17, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Rheum~~]]		[[Category:Rheumatology]]

Neil.m.young: Ref should refer to facts in the article

2016-01-30T23:44:11Z

Ref should refer to facts in the article

← Older revision		Revision as of 23:44, 30 January 2016
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	==References==		==References==
	<references/>		<references/>
	*Lozada CJ et al. Reactive Arthritis. Oct 31 2015. http://emedicine.medscape.com/article/331347-overview#showall.
	[[Category:Rheum]]		[[Category:Rheum]]

Neil.m.young at 23:43, 30 January 2016

2016-01-30T23:43:32Z

← Older revision		Revision as of 23:43, 30 January 2016
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	==See Also==		==See Also==
	[[Ankylosing spondylitis]]		*[[Ankylosing spondylitis]]
			*[[Gonococcal arthritis]]
	[[Gonococcal arthritis]]

	==External Links==		==External Links==