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 ะก 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.
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