Reactive Arthritis: Clinical Features and Treatment

Abstract

Reactive arthritis is a type of spondyloarthritis. It represents the classic interplay of host and environment. This is an inflammatory syndrome that occurs 1–4 weeks, or sometimes longer, after a person is exposed to certain causative organisms. The well-defined bacterial triggers include Chlamydia trachomatis, Salmonella, Shigella, Campylobacter, and Yersinia. Only a minority of patients who develop one of these etiologic infections will develop reactive arthritis. The “classic triad” of symptoms includes inflammatory arthritis, conjunctivitis, and urethritis, but many other disease characteristics have been described. It is also clear that the majority of affected patients do not develop this “classic triad” of symptoms. The majority of patients will experience spontaneous resolution of their symptoms, but a sizeable percentage of patients will develop chronic disease. Recently, it has been suggested that the different types of spondyloarthritis should be classified as axial versus peripheral subtype. This chapter will focus on the different axial and peripheral features of reactive arthritis and attempt to classify it as such. The ideal treatment remains elusive, but the available data will be reviewed.