Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- artritis periférica
- artritis axial
Other diagnostic factors
- síntomas constitucionales
- entesitis
- afectación de la membrana mucosa
- erupción cutánea
- balanitis circinada
- manifestaciones oculares
- manifestaciones cardíacas
Risk factors
- sexo masculino
- genotipo HLA-B27
- infección gastrointestinal o por clamidia previa
- inmunoterapia con BCG
Diagnostic investigations
1st investigations to order
- velocidad de sedimentación globular (VSG)
- proteína C reactiva (PCR)
- anticuerpo antinuclear (ANA)
- factor reumatoide
- cultivos urogenitales y coprocultivos
- estudios radiográficos simples
- artrocentesis con análisis del líquido sinovial
Investigations to consider
- genotipo HLA-B27
- prueba de amplificación de ácidos nucléicos
- Resonancia magnética (IRM)
- ultrasonido
Treatment algorithm
alivio sintomático
artritis reactiva persistente o crónica
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Parker CT, Thomas D. Reiter's syndrome and reactive arthritis. J Am Osteopath Assoc. 2000;100:101-104. Abstract
Dougados M, van der Linden S, Juhlin R, et al. The European Spondylarthropathy Study Group preliminary criteria for the classification of spondylarthropathy. Arthritis Rheum. 1991;34:1218-1227. Abstract
Toivanen A. Managing reactive arthritis. Rheumatology (Oxford). 2000;39:117-119. Abstract
Carter JD, Espinoza LR, Inman RD, et al. Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double-blind, placebo-controlled, prospective trial. Arthritis Rheum. 2010;62:1298-1307. Abstract
Colmegna I, Espinoza LR. Recent advances in reactive arthritis. Curr Rheumatol Rep. 2005;7:201-207. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
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