Reactive arthritis

Last reviewed: 28 Oct 2022
Last updated: 04 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • peripheral arthritis
  • axial arthritis
More key diagnostic factors

Other diagnostic factors

  • constitutional symptoms
  • enthesitis
  • mucous membrane involvement
  • skin rash
  • circinate balanitis
  • ocular manifestations
  • cardiac manifestations
Other diagnostic factors

Risk factors

  • male sex
  • HLA-B27 genotype
  • preceding chlamydial or gastrointestinal infection
  • BCG immunotherapy
More risk factors

Diagnostic investigations

1st investigations to order

  • erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • antinuclear antibody (ANA)
  • rheumatoid factor
  • urogenital and stool cultures
  • plain radiographs
  • arthrocentesis with synovial fluid analysis
More 1st investigations to order

Investigations to consider

  • HLA-B27
  • nucleic acid amplification tests
  • MRI
  • ultrasound
More investigations to consider

Treatment algorithm

ACUTE

symptomatic relief

ONGOING

persisting or chronic reactive arthritis

Contributors

Authors

John D. Carter, MD

Professor of Medicine

Division of Rheumatology

Chief

University of South Florida College of Medicine

Tampa

FL

Disclosures

JDC is on the speakers bureau for Abbvie and Amgen. JDC is a co-author of several references cited in this topic.

Acknowledgements

Dr John D. Carter would like to gratefully acknowledge Dr Jason P. Guthrie, a previous contributor to this topic. JPG declares that he has no competing interests.

Peer reviewers

J.S.H. Gaston, MA, PhD, BM, BCh, FRCP, FMedSci

Professor of Rheumatology

University of Cambridge

Cambridge

UK

Disclosures

JSHG declares that he has no competing interests.

Luis R. Espinoza, MD

Professor and Chief

Section of Rheumatology

Department of Internal Medicine

LSU Health Sciences Center

New Orleans

LA

Disclosures

LRE is a co-author of several references cited in this topic. Unfortunately, we have since been made aware that Dr Luis R. Espinoza is deceased.

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  • Differentials

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    • Psoriatic arthritis
    • Rheumatoid arthritis (RA)
    More Differentials
  • Guidelines

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    More Guidelines
  • Patient leaflets

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    Conjunctivitis

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