Reactive Arthritis - Causes, Symptoms And Treatment Of Reactive Arthritis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Reactive arthritis causes, symptoms and treatment

Content:

• What is reactive arthritis?
• Reactive arthritis symptoms
• Reactive arthritis causes
• Diagnosis of reactive arthritis
• Reactive arthritis treatment
• Prevention of reactive arthritis

What is reactive arthritis?

Reactive arthritis is a severe joint disease that has its own characteristics.

This form of arthritis is accompanied by one or more of the following symptoms:

• Inflammatory processes in the organs of the gastrointestinal tract.
• Conjunctivitis (inflammation of the eyes).
• Inflammatory processes in the genitourinary system.
• Inflammation of the joints.

According to the available statistics, the data of which are published in specialized medical publications and the media, reactive arthritis is most often diagnosed in patients whose age ranges from 30 to 40 years. In men, the most cases of the disease were identified, which were provoked by a genitourinary infection. Representatives of the female and male half of the population are equally often diagnosed with reactive arthritis, which develops against the background of the progression of intestinal infection (dysentery).

According to many experts, reactive arthritis is a rheumatic disease, which in the active stage of its development can affect the vital organs and systems of the human body.

Most often, problems arise in the following organs:

• in the lungs;
• in the kidneys;
• in heart;
• in the soft tissues of the organs of vision;
• on the skin (in the form of a rash, sores or urticaria);
• on the oral mucosa, etc.

In recent years, it is the reactive form of arthritis that is most often diagnosed in the population of different countries of the world, causing severe damage to the musculoskeletal system in people, regardless of age and sexual characteristics. Many rheumatologists believe that if reactive arthritis was not caused by an intestinal or urogenital infection, then it should be classified as Reiter's disease. This is due to the fact that in only 4% of cases with this form of arthritis, infections of the genitourinary system were detected.

Reactive arthritis symptoms

At the initial stage of development, reactive arthritis in most patients manifests itself in an acute form.

According to the results of numerous studies, it was found that the first symptoms of this disease appear 2 weeks after the patient is infected:

1. The temperature rises in the area of the affected joints. To determine the heat in the joint, it is enough to put your hand on the injury site. Compresses are recommended to relieve fever.
2. The joints (ankle and knee, as well as elbow and wrist joints, joints of hands and feet) swell. Sometimes the swelling spreads rapidly beyond the contours of the joints.

3. Pain in the joints develops. Pain occurs, mainly when walking, or performing other movements of the affected lower or upper limb. Many patients experience dull, twisting or aching pains during any physical movement, which subside a little at night. They also experience discomfort when palpating the area of the affected joint.
4. Stiffness of movements appears, caused by a violation of the outflow of articular fluid. Sick people cannot actively move around, exercise.
5. An articular syndrome appears, which is accompanied by pain, asymmetric oligaarthritis, joint damage, swelling, etc.
6. Infections are detected in the genitourinary system, nasopharynx, intestines (accompanied by characteristic symptoms). Urogenital infections accompany such diseases of the genitourinary system as urethritis and cervicitis, and complications developing against them.
7. There is an expansion of the joint space and edema (periarticular) of soft tissues (easily determined by radiography).
8. The eyes, the skin become inflamed (conjunctivitis, irritation of the mucous membrane, weakening of visual activity, urticaria, psoriasiform rashes, stomatitis, etc.).
9. At the initial stage of the development of reactive arthritis, patients show signs of sacroiliitis (damage to the spine), kidney disease, heart disease (tachycardia), and disorders of the nervous system.
10. Fatigue, loss of performance.
11. General malaise, sudden weight loss.
12. Feverish conditions, often accompanied by an increase in temperature, or chills, etc.

Reactive arthritis causes

According to the results of numerous studies carried out by specialists from different countries of the world, it was found that reactive arthritis in most cases develops against a background of poor heredity. Modern medicine is capable of detecting this disease at the genetic level. This is due to special laboratory tests that use reagents that determine the genetic markers HLA-B27. Despite the genetic predisposition, patients will develop reactive arthritis only when they become infected with the disease.

The reasons for the appearance of reactive arthritis include the following provoking factors:

• various bacteria (Salmonella, Yersinia, Shigella, Campylobacter);
• infectious diseases (dysentery);
• abnormalities in the patient's immune system;
• a genetic predisposition to this disease (reactive arthritis is most often detected in carriers of the HLA-B27 antigen);
• infection of the patient with harmful microorganisms that penetrate into the human genitourinary system (for example, chlamydia Chlamydia trachomatis, Ureaplasma urealyticum), etc.

Diagnosis of reactive arthritis

When detecting characteristic symptoms or any discomfort in the area of the joints, the patient should contact a narrow-profile specialist - a rheumatologist.

At the reception, the doctor must correctly collect the anamnesis of this disease, and then prescribe the patient a set of laboratory tests and hardware diagnostics:

• clinical and biochemical blood test;
• general urine analysis;
• other blood tests by which the following indicators are determined: antibodies, antigen, sialic acids, etc.;
• smears from the cervical canal and urethra;
• enzyme immunoassay;
• sowing feces to identify pathogenic microflora;
• PCR analysis;
• sigmoidoscopy;
• radiography (spinal column, joints of the lower and upper extremities);
• fibrocolonoscopy;
• magnetic resonance imaging or computed tomography, etc.

Diagnosis of reactive arthritis is carried out on the basis of the data of the initial examination, during which the specialist identified the main signs of this disease, and the results of laboratory and apparatus examination of the patient. Thanks to timely radiography, the doctor can identify any, even minor, changes in the musculoskeletal system. Sometimes hardware diagnostics can detect calcifications that are located on bone tissues in the area of which inflammatory processes have occurred.

If a patient who has been diagnosed with reactive arthritis has eye inflammation, the attending physician refers him to an ophthalmologist consultation. A narrow-profile specialist will not only determine visual acuity, but also identify the degree of inflammation, after which he will prescribe drug therapy.

Reactive arthritis treatment

After a comprehensive diagnosis of reactive arthritis, the specialist chooses the method according to which this disease will be treated. The method of therapy will directly depend on the location of the disease and the stage of its development.

In most cases, this category of patients is assigned:

• Anti-inflammatory nonsteroidal medications. Against the background of their regular intake, patients may experience various side effects: ulcers appear, gastrointestinal disorders develop, and internal bleeding begins.
• Patients are given corticosteroids to treat reactive arthritis. This group of drugs, including prednisolone, can significantly reduce inflammation in the joints and tendons of the upper and lower extremities. They can be taken in any convenient way: in the form of ointments; in tablet form orally; in the form of injections (injected into the affected joint).
• In the case when a patient has a reactive form of arthritis provoked by sexually transmitted or viral infections, he is prescribed a course of antibiotics.
• In parallel, the patient must take probiotics, the functions of which are to mitigate the effects of antibiotics on the human gastrointestinal tract.
• Patients who have been diagnosed with a persistent form of reactive arthritis are prescribed sulfasilin. This medicine can come with various side effects such as bone marrow suppression and skin rashes. After a course of sulfazilin, patients must undergo laboratory examination and blood tests.
• In case of inflammatory processes in the eyes, special drops are prescribed to patients. Severe inflammation will require more serious treatment, which includes cortisone injections.
• In case of an inflammatory process in the male or female genitals, the attending physician prescribes a course of therapy with creams, which include cortisone.
• In case of reactive arthritis caused by intestinal or urogenital infections, patients are prescribed antibiotics specific for the identified groups of bacteria.
• If a patient has an inflammatory effusion, then specialists take a set of measures to evacuate it from the damaged joint cavity of the upper or lower extremity. In parallel to this category of patients, ointments, creams, gels are prescribed, which contain Dimexide, which has an anti-inflammatory effect.
• For patients diagnosed with reactive arthritis, various physiotherapy procedures are recommended, such as cryotherapy, phonophoresis, synosoidal modulating currents, etc. A course of physiotherapy exercises, during which patients perform specially designed exercises under the supervision of an experienced instructor, is of great benefit in the treatment of this disease.
• After removing the inflammatory process in the area of damaged joints, patients are prescribed medicinal baths. During such water procedures, salts from the Dead Sea are usually used, as well as hydrogen sulphide and sulphide salts. In parallel with the therapeutic baths, you can take a course of mud therapy.

Regardless of what therapy was used to treat reactive arthritis, patients are advised to have regular tests that can show the presence of infection. If any bacteria that can provoke the re-development of reactive arthritis are identified, patients are prescribed a course of therapy that includes a new group of antibiotics (when choosing the most effective drugs, patients are recommended to pass a special analysis).

Disease prognosis

For patients who have undergone complex treatment for reactive arthritis, there is the following prognosis for their future life:

• in 20% of cases, the signs of the disease disappear within 6 months;
• after correctly selected treatment, there is no relapse of the disease;
• in 25% of cases, reactive arthritis becomes chronic, progressing only in the acute phase;
• in 50% of cases, the disease begins to progress with renewed vigor after a certain period of time;
• only in 5% of cases the severe form of reactive arthritis leads to deformation of the spine and joints.

On the subject: Traditional methods of treating arthritis

Prevention of reactive arthritis

In order to prevent reactive arthritis, experts recommend a set of measures:

• avoid casual sexual intercourse, during which you can become infected with urogenital infections;
• observe personal hygiene;
• lead a healthy lifestyle;
• eat healthy foods;
• timely undergo a medical examination, etc.

Author of the article: Kaplan Alexander Sergeevich | Orthopedist

Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.