Reactive arthritis

Overview

Reactive arthritis, previously known as Reiter’s syndrome, is rare type of arthritis caused by bacterial infections, most often in the genital, urinary or gastrointestinal tract. It can cause joint pain and inflammation that may last for three to twelve months.

Reactive arthritis symptoms can be minor at first and then worsen with time. It commonly affects the knees, ankles, and feet and the inflammation can also affect the eyes, skin, and urethra. In most cases, the signs and symptoms may come and go and typically goes away within a year.

Symptoms

The symptoms of reactive arthritis can vary from person to person, and typically appear within one to four weeks after an infection. They may include:

• Joint pain and stiffness: People with reactive arthritis may experience pain on certain joints, mostly on the hips, knees, ankles, and feet.
• Low back pain: Persistent low back pain, which becomes worse at night or in the morning.
• Inflammation of the eye: People with reactive arthritis may experience conjunctivitis.
• Urinary problems: The prostate gland or cervix may become inflamed. Urination may become more frequent and painful or with a burning sensation.
• Enthesitis: This condition caused by reactive arthritis, is characterized by inflammation at the point where the tendons and ligaments attach to bone, which may cause soles and heel discomfort.
• Swelling of fingers or toes: Sausage-like toes or fingers due to severe swelling may occur in severe cases of reactive arthritis.
• Skin problems: Sores and rash on the palms of the hands, soles of the feet, or penis are the common skin problems caused by reactive arthritis.

In some cases, people with reactive arthritis may also experience diarrhea and abdominal pain.

If any symptoms of reactive arthritis persist for a month, especially diarrhea and genital infection, or if they keep recurring, it is important to consult a healthcare provider.

Causes

According to researchers, reactive arthritis is an autoimmune condition. Autoimmune disorders occur when the body attempts to attack germs or viruses but instead attacks healthy tissue. Reactive arthritis occurs as a result of an infection in the body, most commonly in the intestines, genitals, or urinary tract.

Reactive arthritis itself is not contagious; however, the bacteria that can cause it can be transmitted through sexual contact or contaminated food. Only a small percentage of people who are exposed to these bacteria actually develop reactive arthritis. Additionally, the initial infection may not be noticeable, especially if it causes only mild or no symptoms.

Reactive arthritis can be triggered by a variety of bacteria, with some of the most common being Campylobacter, Chlamydia, Clostridioides difficile, Escherichia coli, Salmonella, Shigella, and Yersinia. While some of these bacteria can be sexually transmitted, others are typically foodborne.

Risk factors

Several factors may contribute to the risk of developing reactive arthritis:

• Age: People ages 20 to 40 is more likely to get reactive arthritis.
• Sex: Reactive arthritis caused by foodborne infections can equally affect both men and women. However, men are nine times more likely than females to develop reactive arthritis as a result of sexual interaction.
• Hereditary: Although a particular genetic marker has been associated with reactive arthritis, the majority of individuals with this marker do not develop the condition.