Reiter’s syndrome - Reactive Arthritis - Symptoms - Causes - Diagnosis - Treatment

There are several symptoms associated with Reiter’s syndrome but the symptoms associated with polyarthritis such as pain, swelling and heat in the joints, dominates the clinical scenario.

The symptoms and signs of Reiter's can be divided into those that affect the joints and those that affect the non-joint areas of the body.

Joint Symptoms & Signs

The joints that may get involved include the knees, ankles, feet, and wrists. Usually these involvements are asymmetric e.g. if it is knee on the left side it maybe wrist on the other side and this may not happen simultaneously.

The arthritis leads to inflammation of the joints and this manifests as –

• Stiffness,
• Pain,
• Swelling,
• Warmth,
• Redness of the joints involved.
• If fingers get involved it can look like a "sausage digit."

Spine can sometimes get involved leading to pain and stiffness in the neck or back.

If cartilage joints are involved it causes pain in the front section of the chest called costochondritis.

If tendons get involved it cause tendinitis – e.g. the heel or knee may get involved.

Non- Joint Symptoms & Signs

Inflammation of non-joints regions of the body especially Urethra and conjunctiva of the eyes is typical of Reiters syndrome. However other regions can also get involved and include – bladder, prostate gland, mouth lining, large bowel, aorta and the iris of the eye (iritis).

Symptoms & signs when the genital region is ionvolved include-

• Stinging or burning sensation when passing urine
• Urgency and Frequency of urine
• Inflammation of penis underneath the foreskin

In women the genital infection can additionally lead to –

• Cervicitis
• Vulvovaginitis
• Salpingitis

Eye involvement causes -

• Irritation in the eye
• Photophobia or pain when looking into bright lights

Mouth ulceration may be present but these are usually painless

Bowel involvement or colitis can cause diarrhea

Reiter’s syndrome symptoms generally appear within a month of the trigerring episode.

Other symptoms associated with Reiter’s syndrome include-

• Fever, weight loss, fatigue and loss of appetite.
• Penile lesions in men (circinate balanitis)
• Rashes at the bottom of the feet (keratoderma blennorrhagica)

Genital lesions usually occur when the Reiter’s syndrome is sexually induced or when it is associated with enteric organism Shigella.

Rare Complications of Reiters include –

Heart problems such as:

• Aortic Valve dysfunction leading to heart murmer and failure
• Heart conduction problems - arrhythmias
• Pericarditis (inflammation of outer lining of heart)

Lung problems such as:

• Pneumonia
• Pulmonary fibrosis
• Pleural effusion or Fluid in the lung

Nervous system problems such as:

• Tingling or loss of sensation or Neuropathy