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==Differentiating Reactive Arthritis from other Diseases==
==Differentiating Reactive Arthritis from other Diseases==
Reactive arthritis should be distinguished from other diseases causing arthritis of the peripheral skeleton, which present as [[arthralgia]]. The differentials include:
<small>
{| class="wikitable"
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Arthritis Type
! colspan="7" align="center" style="background:#4479BA; color: #FFFFFF;" ! + |Clinical Features
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" ! + |Body Distribution
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" ! + |Key Signs
! colspan="4" align="center" style="background:#4479BA; color: #FFFFFF;" ! + |Laboratory Abnormalities
|-
|
|'''History of Psoriasis'''
|'''Symmetric [[joint]] involvement'''
|'''Asymmetric [[joint]] involvement'''
|[[Enthesopathy|'''Enthesopathy''']]
|'''[[Dactylitis]]'''
|'''[[Nail (anatomy)|Nail]] [[Dystrophy]]'''
|'''[[Human Immunodeficiency Virus (HIV)|Human immunodeficiency virus]] association'''
|'''[[Upper extremity]]-hands'''
|'''[[Lower extremity]]'''
|'''[[Sacroiliac joint|Sacroiliac joints]]'''
|'''[[Spine]]'''
|'''[[Osteopenia]]'''
|'''[[Joint]] Space'''
|'''[[Ankylosis]]'''
|'''[[Periostitis]]'''
|'''[[Soft tissue]] swelling'''
|'''[[ESR]]'''
|'''[[Rheumatoid factor]] ([[Rheumatoid factor|RF]])'''
|'''[[HLA-B27]]'''
|-
|'''[[Psoriatic arthritis]]'''
| +
| +
| ++
| +
| +
| +
| +
| +++ ([[Distal interphalangeal joints|DIP]]/[[Proximal interphalangeal joints|PIP]])
| +++
| ++ (Unilateral)
| ++
| -
| ++ (Widening)
| ++
| +++ (Fluffy)
| ++
| +
| -
|30-75%
|-
|'''[[Rheumatoid arthritis]]'''
| -
| ++
| +
| -
| -
| -
| -
| +++
([[MCP joints|MCP]]/[[wrist]])
| +++
| + (Unilateral)
| ++([[Cervical spine|Cervical]])
| +++
| +++ (Narrowing)
| +
| + (Linear)
| +++
| +++
| +++
|6-8%
|-
|'''[[Ankylosing spondylitis]]'''
| -
| +++
| -
| +
| -
| -
| -
| +
| +
| +++ (Bilateral)
| +++
| +++
| ++ (Narrowing)
| +++
| +++ (Fluffy)
| +
| +++
| -
|90%
|-
|'''[[Reactive arthritis]] ([[Reiter's syndrome]])'''
| -
| +++
| -
| +
| +
| -
| -
| ++
| +++
| ++ (Unilateral)
| +
| +
| + (Narrowing)
| -
| +++ (Fluffy)
| ++
| ++
| -
|75%
|}
Key:+ : Infrequently present, ++ : Frequently present, +++ : Always present, - : Absent


==References==
==References==

Revision as of 02:27, 14 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differentiating Reactive Arthritis from other Diseases

Reactive arthritis should be distinguished from other diseases causing arthritis of the peripheral skeleton, which present as arthralgia. The differentials include:

Arthritis Type Clinical Features Body Distribution Key Signs Laboratory Abnormalities
History of Psoriasis Symmetric joint involvement Asymmetric joint involvement Enthesopathy Dactylitis Nail Dystrophy Human immunodeficiency virus association Upper extremity-hands Lower extremity Sacroiliac joints Spine Osteopenia Joint Space Ankylosis Periostitis Soft tissue swelling ESR Rheumatoid factor (RF) HLA-B27
Psoriatic arthritis + + ++ + + + + +++ (DIP/PIP) +++ ++ (Unilateral) ++ - ++ (Widening) ++ +++ (Fluffy) ++ + - 30-75%
Rheumatoid arthritis - ++ + - - - - +++

(MCP/wrist)

+++ + (Unilateral) ++(Cervical) +++ +++ (Narrowing) + + (Linear) +++ +++ +++ 6-8%
Ankylosing spondylitis - +++ - + - - - + + +++ (Bilateral) +++ +++ ++ (Narrowing) +++ +++ (Fluffy) + +++ - 90%
Reactive arthritis (Reiter's syndrome) - +++ - + + - - ++ +++ ++ (Unilateral) + + + (Narrowing) - +++ (Fluffy) ++ ++ - 75%


Key:+ : Infrequently present, ++ : Frequently present, +++ : Always present, - : Absent

References


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