Arthritic Reactive

Arthritis reactive is a term used to refer to arthritis developing after infection, but not caused by the ingress of an infectious agent into the joint cavity. Usually reactive arthritis is of an immunocomplex character, that is, it arises from immunity disorders in genetically predisposed individuals due to insufficient utilization of antigen-antibody complexes by a macrophage system. Reactive arthritis can develop after many infections (bacterial, viral, etc.) regardless of their severity, but more often after enterocolitis caused by Yersinia, and urinary tract infections caused by chlamydia.

The number of affected joints is usually small, arthritis is often asymmetric. Mostly the joints of the lower extremities, especially the toes, are inflamed, where the periarticular edema, which spreads to the entire finger, and the cyanotic or crimson-cyanotic color of the skin also develop (the finger looks like a sausage or radish). In addition to arthritis, the development of enthesopathies is typical - the inflammation of the tendons in places where they attach to the bones, especially often in the heel region. Individual patients may have pain in the spine. In many cases, reactive arthritis is short-lived (from several days to several weeks), passes by itself, but in some patients it may be delayed for a longer period and even become chronic.

Sometimes extra-articular manifestations are noted: skin lesions are more often in the form of psoriasis-like rashes, mucous membranes of the oral cavity (erosion), external genitalia (balanoposthitis, vaginitis), eye (conjunctivitis), and heart (myocarditis, pericarditis), peripheral nervous system (neuritis) And others. When combined with urethritis, conjunctivitis and arthritis, Reiter's syndrome is diagnosed.

Treatment is carried out mainly with non-steroidal anti-inflammatory drugs (indomethacin, orthophene, naproxen) and intra-articular administration of corticosteroids. With the signs of infection, confirmed microbiologically, the corresponding anti-infectious agents are shown (with yersiniosis and chlamydia - usually tetracycline in a dose of 2 g / day). With prolonged flow, plasmapheresis is carried out.