Reactive arthritis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Obtaining history is an important aspect in making a diagnosis of reactive arthritis. The areas of focus should be on onset, duration, and progression of symptoms with special focus on past medical history and current medications. Previous history of gastrointestinal or genitourinary infections may predispose an individual to develop reactive arthritis. Symptoms start to appear after days to weeks of initial gastrointestinal or genitourinary infection. Common symptoms of reactive arthritis include urinary changes (increased frequency, burning and urgency), irritation and redness of eyes, and joint pain (commonly of lower limbs). Less common symptoms include inflammation of soft tissue, swollen toes, and skin rash. If symptoms are present for more than six months, it is termed as chronic reactive arthritis.

History and Symptoms

History

Obtaining history is an important aspect in making a diagnosis of reactive arthritis. It provides insight into cause, precipitating factors and associated comorbid conditions. Complete history will help determine the correct therapy and helps in determining the prognosis. Specific histories about the symptoms (duration, onset, progression), associated symptoms, drug usage have to be obtained. Specific areas of focus when obtaining the history, are outlined below:

• Joint pain
• Back pain
• Urinary changes
• Visual disturbance
• Fatigue
• Fever

Common Symptoms

Common symptoms of reactive arthritis include:

• Urinary changes (increased frequency, burning and urgency)
• Irritation and redness of eyes
• Joint pain (commonly of lower limbs)

Less Common Symptoms

Less common symptoms of reactive arthritis include:

• Inflammation of soft tissue
• Swollen toes
• Skin rash

Diagnosis revealed that the rash on the bottom of this individual’s feet, known as keratoderma blennorrhagica, was due to Reiter's syndrome' Dr. MF Rein.

Acute reactive arthritis

The classic symptoms of reactive arthritis include urethritis, arthritis, and conjunctivitis

• Symptoms start to appear after days to weeks of initial gastrointestinal or genitourinary infection.
• Mono or oligoarticular arthritis
• Commonly affects lower extremities
• Dactylitis
• Enthesitis
• Symptoms for more than six months are regarded as chronic reactive arthritis