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Artrite reativa

Last reviewed: 18 Aug 2025
Last updated: 04 Feb 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • artrite periférica
  • artrite axial
Full details

Other diagnostic factors

  • sintomas constitucionais
  • entesite
  • comprometimento da membrana mucosa
  • erupção cutânea
  • balanite circinada
  • manifestações oculares
  • manifestações cardíacas
Full details

Risk factors

  • sexo masculino
  • genótipo HLA-B27
  • infecção gastrointestinal ou por clamídias anterior
  • imunoterapia com BCG
Full details

Diagnostic investigations

1st investigations to order

  • velocidade de hemossedimentação (VHS)
  • proteína C-reativa
  • FAN
  • fator reumatoide
  • coproculturas e culturas de material urogenital
  • radiografias simples
  • artrocentese com análise do líquido sinovial
Full details

Investigations to consider

  • HLA (antígeno leucocitário) B27
  • testes de amplificação de ácido nucleico
  • RNM
  • ultrassonografia
Full details

Treatment algorithm

ACUTE

alívio sintomático

ONGOING

artrite reativa persistente ou crônica

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

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

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.
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