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 arthritis.
Diagnosis
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