Reactive Arthritis

This is also known as Reiter’s syndrome. It's a mono-arthritis, typically occurring after a preceding STI or gastroenteritis. The most common preceding infections are Chlamydia, Shigella, and Salmonella.

Risk factors - Male, HLA-B27 +ve

Presentation - "Can't see, Can't pee, Can't climb a tree"

• "Can't see" = Conjunctivitis - discharge, erythema, burning, photophobia

• "Can't pee" = Urethritis - dysuria, urgency, frequency, discharge

• "Can't climb a tree" = Arthritis - pain, swelling in knee/ankle/foot

An important differential here is Septic Arthritis (The joint in reactive arthritis doesn't contain any infection itself, so joint aspiration will be negative).

Management

• Exclude Septic Arthritis! - Joint aspiration and MC&S

• NSAIDs, Steroids

• Most resolve within 6 months