Reactive Arthritis - Symptoms - Causes - Diagnosis - Treatment

What is Reactive Arthritis?

Reactive arthritis is an autoimmune condition that was first described by a German military physician Hans Reiter in 1918. He discovered this disease as he was examining a World War I Prussian soldier who was recuperating from a bout of diarrhea. The three characteristic features he described included - inflammation of the joints, urinary tract, and eyes. Since then doctors have identified a fourth major feature - ulcerations of the skin and mouth.

‘Reactive’ Arthritis as the arthritic inflammation in this condition is usually the result of an infection affecting another body part. Spinal inflammation has gained the disease the name Spondyloarthropathy. When arthritis and urethritis alone are present (conjunctivitis absent) the term Abortive Reactive Arthritis is used. It has been suggested that the term Reactive Arthritis be discouraged from usage due to Dr. Reiter’s experimental work in the concentration camps of the Nazis and also because there is an effort to stop assigning personal names to diseases. The disease is primarily characterized by a triad of manifestations - conjunctivitis, arthritis, and urethritis; Although urethritis (urinary tract infection) usually occurs first, the clinical manifestations are dominated by polyarthritis and characterized by pain, redness, swelling and heat in the joints.

Some of the other disorders associated with Reactive Arthritis are ankylosing spondylitis, psoriatic arthritis, and inflammatory bowel syndrome. Reactive Arthritis may be acute in the vast majority of affected individuals in whom the condition will resolve on its own in a period of one year. In some it may recur frequently for many years and this will lead to the condition becoming chronic.

Nearly 40 % of patients with Reactive Arthritis develop disabling arthritis, kidney or heart disease or impaired vision. The etiology is yet unclear but this autoimmune disease is believed to be triggered by Pleuro pneumonia- like viral organisms or Chlamydia. The condition usually manifests itself after a bout of infection involving the gastric mucosa (stomach lining), genital region or the lower urinary tract. Treatment for Reactive Arthritis is focused at controlling the symptoms and eliminating microbial infection. The disease usually affects Caucasian men between the ages of 16 and 42 years of age, although it is also known to occur in older people and smaller children.

Most cases involve adults in their forties. One fifth of the women are affected as often as men and when it occurs, women get the post -dysenteric form of the disease. They are less likely to have the arthritic symptoms. The sexually transmitted form is more prevalent among sexually active young men. The disease is a rarity among Black males. People affected by Reactive Arthritis have the potential to enjoy a normal span of life thanks to lifestyle modifications and excellent treatments available. Early diagnosis of the patient is important to prevent the development of arthritic complications.