Reactive arthritis

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body
mostly in genitals, intestines, genitals and urinary tracts.
This condition usually targets the knees, ankles and feet. Inflammation also can affect the eyes,
skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis was
sometimes called Reiter’s syndrome.
Sign and symptoms
Incubation period is 1 to 4 weeks.
Pain and stiffness- pain in joints of knee, ankles, low back, heels.
Eye – people who have this arthritis develops an eye inflammation ( conjunctivitis ).
Urinary problems: inflammation of prostate gland and cervix, discomfort during urination.
● Reactive arthritis occurs in reaction to an infection by certain bacteria. Most often, these
bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella,
Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms but can
cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If
you develop arthritis within one month of a gastrointestinal or a genital infection especially with
a discharge see a health care provider. You may have reactive arthritis.
Reactive arthritis tends to occur most often in men between ages 20 and 50. Some patients
with reactive arthritis carry a gene called HLA-B27. Patients who test positive for HLA-B27 often
have a more sudden and severe onset of symptoms. They also are more likely to have chronic
(long-lasting) symptoms. Yet, patients who are HLA-B27 negative (do not have the gene) can still
get reactive arthritis after exposure to an organism that causes it.
Patients with weakened immune systems due to AIDS and HIV can also develop reactive
There is no specific test for diagnosing reactive arthritis, but the doctor may check the urtheral
discharge for STD. Stool samples may also be tested. Blood reports shows positive for the HLAB27 genetic marker and alongwith wbc count esr increases. Patient will also have less rbc.
X rays reports shows bone loss, signs of osteoporosis , bony spurs , back joints and pelvis may
show abnormalities.
Doctor will also test for eye and UTI which can confirm the disease.
Treatment/ Medical Management
Microbial therapy is strongly recomended for 3 to 6 months for an microbial infection.
Antibiotics should be started soon without any delay. NSAIDS are the first choice of treatment.
Main goal is to reduce the symptoms and prevent complication.
Mechanical devices like orthotics, insoles can be used.
Medical management:
Goal of physiotherapy management
1) reduce inflammation
2) reduce pain
3) improve rom
4) increase cardiovascular fitness
Cryotherapy should be intiated to intiated early at acute stage to control inflammation and
swelling around the affected joints.
Electrical stimulations like TENS, IFT to ease pain . Range of motion and stretching exercises
for all joints to avoid any stiffness in the joint, strengtheing exercises will be intiated to improve
power of muscles.
Patient education – this is necessary to promote joint protection and proper body mechanics
when performing daily activities to maintain joint integrity.
Aerobic exercises should include low impact activities such as swimming, walking depending on
patient’s age and cardiovascular level.
Other advance techniques like dry needling and taping have shown great benefits in releiving
pain and stiffness.
Physiotherapy management will target the affected joint and its attachments