REACTIVE ARTHRITIS AND REITER’S DISEASE
Aseptic arthritis associated with genital tract infection is the commonest cause of acute arthritis in young adults.
Reiter’s disease is a syndrome characterised by reactive arthropathy, eye involvement and urethritis. It usually follows infection with С trachomatis. It is IS times more common in men than in women and is manifested by urethritis with one or more extragenital immune complications such as arthritis of the knees, ankle, spine (notably a sacroiliitis), metatarsophalangeals, wrists, elbows or tarsals, plantar fasciitis, conjunctivitis or uveitis or skin involvement (circinate balanitis or keratoderma blenorrhagica). Symptoms may occur together or sequentially. The acute disease is usually self-limited and remits after a few months. Recurrence is common. About 10% of patients develop chronic disease. Cardiac conduction disturbance or aortic incompetence may develop after some years.
Reiter’s disease may be a rare complication of gonococcal urethritis. It may also complicate gastrointestinal infections particularly shigellosis, but also infections due to salmonella and yersinia.
Reiter’s disease is one of a group of reactive arthropathies including ankylosing spondylitis and psoriatic arthritis which are commonly associated with the HLA-B27 histocompatability antigen.
*32/56/1*
