Reactive Arthritis

Reactive arthritis is a type of arthritis that develops in response to an infection elsewhere in the body. Most often, this infection has occurred in the digestive tract or urogenital tract. Reactive arthritis can cause inflammation of the urinary tract, the joints, and the eyes. For patients who have been diagnosed with this form of arthritis, treatment options include several different kinds of medication, including antibiotics and corticosteroids, among others.

 

What Is Reactive Arthritis?

Reactive arthritis is a form of arthritis, or joint inflammation, that occurs as a reaction to an infection elsewhere in the body. It is also known as Reiter's syndrome, and your doctor may refer to it by yet another term: seronegative spondyloarthropathy.
 

What Are Spondyloarthropathies?

The spondyloarthropathies are a group of arthritic diseases that can cause inflammation throughout the body, especially in the spine. They are characterized by a positive HLA-B27 and negative rheumatoid factor.
 
Besides reactive arthritis, this group of conditions include:
 

Who Gets Reactive Arthritis?

Overall, men between the ages of 20 and 40 are most likely to develop reactive arthritis. However, evidence shows that although men are nine times more likely than women to develop reactive arthritis due to a sexually transmitted disease (STD), women and men are equally likely to develop reactive arthritis as a result of foodborne infections. Women with reactive arthritis often have milder symptoms than men.
 

Reactive Arthritis: Cause

Scientists and doctors do not know the exact cause or causes of reactive arthritis. They do know that reactive arthritis can occur following an infection in the digestive tract or urogenital tract. Also, it is likely that genetics plays a role. However, researchers still do not understand why one person can develop reactive arthritis while another does not.
 
Certain types of bacteria related to reactive arthritis include:
 
(Click Causes of Reactive Arthritis for more information on these infections and how they are thought to increase the risk for reactive arthritis.)
 

Symptoms of Reactive Arthritis

Inflammation is a characteristic reaction of tissues to injury or disease, and is marked by swelling, redness, heat, and pain. Besides this joint inflammation, reactive arthritis is associated with two other symptoms: redness and inflammation of the eyes (conjunctivitis) and inflammation of the urinary tract (urethritis). These symptoms may occur alone, together, or not at all.
 
The symptoms of reactive arthritis usually last 3 to 12 months, although symptoms can return or develop into a long-term disease in a small percentage of people.
 
(Click Reactive Arthritis Symptoms for more information on possible symptoms in the joints, eyes, and the urogenital tract.)
 

Is Reactive Arthritis Contagious?

Many people wonder whether reactive arthritis -- since it can be the result of an infection with bacteria -- is contagious. Reactive arthritis is not contagious; that is, a person with the disorder cannot pass the arthritis on to someone else. However, the bacteria that can trigger reactive arthritis can be passed from person to person.
 

Diagnosing Reactive Arthritis

In order to diagnose reactive arthritis, the healthcare provider will begin by asking a number of questions. He or she will then perform a physical exam looking for signs of reactive arthritis. If he or she suspects reactive arthritis, certain tests may be recommended. These tests include blood tests and x-rays.
 
Before making a diagnosis of reactive arthritis, the healthcare provider will make sure you do not have other conditions that share similar symptoms with reactive arthritis. These include:
 

 

(Click Reactive Arthritis Diagnosis for more information.)

     

Treatment for Reactive Arthritis

Reactive arthritis can be difficult to treat; therefore, your healthcare provider may have to try several medicines or a combination of medicines before finding out what works. There is no cure for reactive arthritis.
 
Examples of medicines that may be prescribed for reactive arthritis treatment include:
 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids (either injections or topical)
  • Antibiotics
  • Immunosuppressive medicines
  • TNF inhibitors, such as:

 

 

(Click Reactive Arthritis Treatment for more information related to treatment options. This includes a discussion about exercise and how it can be useful for treating reactive arthritis.)
 

Prognosis Following Reactive Arthritis Treatment

Most people with reactive arthritis recover fully from the initial flare of symptoms and are able to return to regular activities two to six months after the first reactive arthritis symptoms appear. In such cases, the symptoms of arthritis may last up to 12 months, although these are usually very mild and do not interfere with daily activities.
 
Approximately 20 percent of people with reactive arthritis will have chronic (long-term) arthritis. While the symptoms are most often mild, a number of people will continue to have significant joint symptoms that cause them either to not be able to work or to have no choice but to switch jobs. Chronic heel pain is often a particularly distressing symptom.
 
Studies show that between 15 and 50 percent of patients will develop symptoms again after the initial flare has disappeared. Such relapses may be due to reinfection. Back pain and arthritis are the symptoms that most commonly reappear.
 
Anyone with a history of reactive arthritis should practice safer sex. This is to decrease the chances for a reoccurrence.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD