What is Reactive Arthritis (Reiter’s Syndrome)?

Reactive arthritis (Reiter's syndrome) is a rather rare, temporary kind of inflammatory arthritis precipitated by an infection from a bacterium. It can be very disabling, with painful stiffness in your joints, most commonly the lower body. Symptoms may also arise in other tissues in your body, like your eyes or skin, or be more widespread, such as a general feeling of malaise. Unlike most types of arthritis, it is temporary and usually goes away in less than a year.

Reactive arthritis is caused by an infection in your urinary tract, genitals, digestive system or throat that causes an abnormal reaction by your immune system. Your immune system usually develops inflammation to eliminate infections. However, in Reiter's syndrome, your immune system sends inflammation to areas of your body that never had the infection. It's like it isn't convinced that the fight is over.

What are the symptoms of reactive arthritis?

The most common symptoms of reactive arthritis are joint and lower back pain and stiffness, most commonly in:

The lower back
The knees
The ankles
The feet

However you may also experience a wide range of other symptoms, including:

Eye pain with swelling and redness
Some gastrointestinal symptoms, including stomach ache or diarrhea
Frequent need to urinate and pains when trying to urinate
Irritating rashes on your skin and ulcers inside your mouth
Achilles tendinitis and heel pains
Swollen joints, especially in the fingers and toes ('sausage fingers').
Flu-like symptoms, such as fever, fatigue, and muscle aches.

What is the 'triad' of reactive arthritis symptoms?

The textbook triad of reactive arthritis symptoms are:

Arthritis (joint inflammation).
Conjunctivitis (eye inflammation).
Urethritis (inflammation in your pee passageway).

This triad makes for a rapid diagnosis for Reiter's syndrome. But most of you will not have all of these manifestations simultaneously. Alternate symptoms may occur and then remit. You could never experience the full triad, and you can also have other symptoms that are not included in the classic triad.

What cause Reiter's syndrome?

Reactive arthritis is an infectious process. It is typically a:

Urinary tract infection (UTI).
STI.
Gastroenteritis, infectious, for example, food poisoning
Pharyngitis, or sore throat
Amongst the most specific pathogens that can cause it include,
Chlamydia
Gonorrhea
Salmonella
Shigella
Campylobacter
Yersinia
Mycoplasma
C. difficile
Streptococcus.

Reiter's syndrome generally starts several days to weeks after the original infection has resolved in only a small percentage of those infected. It appears that the infection triggers an autoimmune response. This means your immune system overcorrects and starts attacking healthy parts of your own body with inflammation. Fortunately, unlike most autoimmune diseases, reactive arthritis is generally a temporary condition.

Reactive arthritis is one of a group of inflammatory arthritis diseases called spondyloarthritis. Most of these are autoimmune conditions. Scientists do not know why some people develop autoimmune conditions and others do not. You do not have to have a bad infection to get reactive arthritis. One possible risk factor is a gene called HLA-B27. Many people who get spondyloarthritis and Reiter's syndrome have the gene.

Who gets Reiter's syndrome?

Anyone can come down with reactive arthritis, but you are at higher risk if:
You are less than 40 years old and male
You have HIV
You already have another autoimmune disease
You have the HLA-B27 gene

How is reactive arthritis diagnosed?

If you have come up with a new onset of arthritis symptoms, your doctor will be interested to see and hear about your condition. Some syndromes of the disease are indicative of reactive arthritis. They will, therefore, be interested in knowing if you have recently recovered from an infection that may have triggered Reiter's syndrome.

You will undertake various tests to aid in diagnosing. These comprise of:

X-rays.
Computed tomography (CT scan).
Magnetic resonance imaging (MRI).
Joint aspiration, which is a medical term meaning arthrocentesis.
Throat culture.
Urinalysis.
Blood tests.

How do you treat Reiter's syndrome?

Treatment for reactive arthritis may include:

Antibiotics: Depending on the infection that triggered it, and whether it's still active, in some cases, a course of antibiotics, like doxycycline and rifampin, can halt or shorten reactive arthritis.
NSAIDs: Your provider may prescribe a short-term high dose of a potent nonsteroidal anti-inflammatory drug (NSAID), such as indomethacin. Once your symptoms have improved, they will taper off your medication.
DMARDs: Disease-modifying anti-rheumatic drugs (DMARDs) such as sulfasalazine reduce some of the activity of your immune system to treat inflammatory arthritis. They can be helpful if NSAIDs aren't working.
Corticosteroids: Though most people with Reiter's syndrome don't respond to oral steroids, these aggressive anti-inflammatory drugs can be helpful when applied topically in creams or injected into a joint.

Can reactive arthritis be cured?

Reiter's syndrome is often self-limiting, which means that it runs its course and resolves on its own within three to 12 months. In the meantime, symptoms often can be suppressed by treatment, which may make symptoms disappear more quickly, but reactive arthritis is an autoimmune disease. No autoimmune disease is actually curable. This means it's always possible for symptoms to return—for example, if you acquire another infection.

In a very small percentage of patients, Reiter's syndrome seems to become more serious and chronic form of spondyloarthritis. They establish longterm arthritis of joints that can cause potential real tissue damage. It is not understood if it is merely chronic reactive arthritis or if, in this case, you actually have another different disease. One autoimmune disease can lead to another, and it is common for persons with the disease to have two or more.

Living With

How do I manage myself when I have Reiter's syndrome?

Although it likely will be temporary, reactive arthritis can change your life in ways that get to you until you recover from the condition. While most people have few, if any, fluctuations in symptoms which tend to resolve on their own, some people have extreme fatigue and pain. You may need to adjust your routine or how you go about your business when you have reactive arthritis.

Your physician can advise

Physical therapy: A PT can provide recommendations on exercises you can do that do not overstretch the muscles and tendons surrounding your sore joints, which can also reduce stiffness.
Orthotics: An occupational therapist can make recommendations about how you can support those joints you use most or change how you use those joints. You may need a brace, splint, or shoe insert.
Hot/cold therapy: Ice packs and heat packs can help ease soreness in different ways. Your physician could say, for example, that you should use ice on your aching joints and heat on your sore muscles.
Power naps: Chronic fatigue can be debilitating; however, prolonged bed rest is not going to ease your sore joints or tight muscles. Instead, take short naps and get up and around in between.

Why choose Tender Palm Super-Speciality Hospital for Reactive Arthritis Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Reactive Arthritis treatment in Lucknow, India, at an affordable cost. We have a team of experienced rheumatologists and infectious disease specialists who provide accurate diagnosis with advanced imaging and microbiological testing, personalized medical care, and both antibiotic therapy and anti-inflammatory treatment options. Our Rheumatology and Infectious Disease team has decades of experience in successfully treating Reactive Arthritis in Lucknow, India.