Reactive Arthritis

Basics

Possibly 1st described in the 4th century bc by Hippocrates
Reactive arthritis (ReA) is part of the spectrum of spondyloarthropathies
Characterized by triad of conjunctivitis, urethritis, and arthritis
Syndrome classically includes triad of conjunctivitis, urethritis, arthritis
Previously known as “Reiter syndrome,” and now referred to as ReA according to the American College of Rheumatology:
- Typically taught as the syndrome of “can't see, can't pee, can't climb a tree”
Can be accompanied by other extra-articular manifestations
More common in adult males

Infection-induced systemic illness
Genetic predisposition in HLA-B27 carriers
Exact incidence difficult to determine because of lack of standardized diagnostic criteria
Typically occurs after infection with gastrointestinal or genitourinary pathogens:
- GI:
  - Salmonella, Shigella, Campylobacter, Yersinia, Clostridium difficile
- GU:
  - Chlamydia trachomatis (most common cause), Neisseria gonorrhoeae
Also described after upper respiratory infections, UTIs, BCG treatment for bladder carcinoma
Peak onset during 3rd decade

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