Reactive Arthritis

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is reactive arthritis?

Arthritis is an umbrella term that covers several conditions that affect the joints. Reactive arthritis, previously known as Reiter’s syndrome, is a rare form of arthritis, affecting up to 27 people out of every 100,000 in the United States.

Reactive arthritis affects the joints and the eyes. It also can affect the urinary tract, which includes the bladder and urethra. It is triggered by a bacterial infection elsewhere in the body—a reaction to the infection—hence the condition’s name.

People of any age can develop reactive arthritis but men ages 20 to 40 are most frequently diagnosed with it. There is no cure for reactive arthritis, although treatment may help eliminate the initial infection that triggered it and may help control the pain.

Reactive arthritis is not a life-threatening disorder but it can affect your quality of life. Most people who have reactive arthritis recover within a few months, but the condition can become chronic, causing long-term pain. Seeking help from your doctor when you start to notice symptoms can help reduce the risk of long-term effects.

What are the symptoms of reactive arthritis?

The most common symptoms of reactive arthritis are similar to other types of arthritis, but there are also other symptoms that are unique to this type. They include:

  • Blurry vision

  • Conjunctivitis (inflammation and redness of the eyes)

  • Heel spurs

  • Increased urination

  • Inflammation in the cervix, fallopian tubes, vulva and vagina

  • Inflammation of tendons where they meet bone

  • Lower back pain

  • Penile discharge

  • Prostatitis

  • Rash on the palms of the hand and soles of the feet

  • Stiff, painful joints, especially of the knees, ankles and feet

  • Swelling around the toes and fingers

See your doctor as soon as possible after symptoms develop to help prevent them from progressing and causing more pain and discomfort.

What causes reactive arthritis?

Reactive arthritis is triggered by a bacterial infection. Reactive arthritis is the body’s reaction to the infection, several days or weeks after the infection began. The infection can be anywhere in your body, but most commonly reactive arthritis results from infections in the urinary tract, genitals or intestines. It can also be caused by a sexually transmitted infection. Those infections are called sexually acquired reactive arthritis, or SARA.

Not all infections will trigger reactive arthritis. The most common ones associated with reactive arthritis are caused by these bacteria:

  • Campylobacter jejuni

  • Chlamydia pneumoniae (rare)

  • Chlamydia trachomatis

  • Salmonella

  • Shigella

  • Yersinia enterocolitica

What are the risk factors for reactive arthritis?

The strongest risk factor for reactive arthritis is having an infection. There are a few others as well, such as:

  • Being male

  • Being between 20 and 40 years old

  • Positive lab testing for the human leukocyte antigen HLA-B27 

  • Having a family history of reactive arthritis

If you have any risk factors, you can reduce the risk of long-term effects of reactive arthritis by speaking to your doctor as soon as you notice any symptoms. You can also reduce the risk of developing reactive arthritis by protecting yourself from infections, particularly sexually transmitted infections and infections caused by eating contaminated food.

How do doctors diagnose reactive arthritis?

Doctors may not always diagnose reactive arthritis immediately because the symptoms occur days or weeks after the infection that triggered it. There is no specific test that can diagnose reactive arthritis. Therefore, it is important to be clear when answering questions as your doctor tries to get a complete picture of your health.

To diagnose your condition, your doctor or licensed healthcare practitioner will ask you several questions including:

  • How long have you had these symptoms?

  • Have you had any other health issues? 

  • Have you recently had any infections?

  • Has anyone in your family been diagnosed with reactive arthritis?

Your doctor may order some of these diagnostic tests:

  • Blood tests to measure red blood cells and look for infections

  • Urethral discharge swabs to check for infection

  • Joint aspiration, in which a doctor uses a needle to remove fluid from a joint

  • Urine tests

  • Stool tests

  • X-rays

  • Gene testing

What are the treatments for reactive arthritis?

In the acute phase, new presentation of the symptoms not long after the infections may be treated with antibiotics. Inflammation in the joints might be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or medications usually used to treat rheumatoid arthritis, such as etanercept or methotrexate. Corticosteroids may be prescribed if there are symptoms affecting the eyes. Topical steroid creams may be used to treat skin rashes.

People who develop chronic reactive arthritis may need to take long-term arthritis medications. They may also need to have physical or occupational therapy if the range of motion of the joints is affected.

What are the potential complications of reactive arthritis?

Overall, reactive arthritis usually goes away after a few months, but sometimes it can become chronic. If it is severe, reactive arthritis can cause joint damage.

Early treatment can help reduce the risk of long-term pain and disability.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 4
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