Reactive arthritis can occur following an infection in a joint-external organ, such as the genitourinary system or the digestive system. This is a type of arthritis that can cause significant suffering for patients if it persists.
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Hand joints (Photo: Health & Life) |
Reactive arthritis is a non-infectious inflammatory arthritis that has a systemic nature due to damage in various extra-articular organs such as conjunctivitis, urethritis, colitis, and glomerulonephritis. The disease often occurs in individuals aged 20-40, and is rare in children and the elderly. Males account for two-thirds of the patients.
The pathogenesis of reactive arthritis is currently unclear. Recent studies indicate that this condition is a group of immune-mediated diseases involving pathogens like Chlamydia trachomatis, Salmonella, Yersinia, among others. Clinical manifestations are varied and can range in severity, including:
Inflammation of the peripheral joints, primarily in the lower limbs and asymmetrical, with the most common being knee arthritis and ankle arthritis.
Lower back pain and unilateral or bilateral hip pain.
Periarticular soft tissue inflammation: Inflammation of ligaments, tendons, muscle fascia, tendon insertion points, and joint capsules (such as the Achilles tendon). Symptoms may include swelling of the toes and fingers resembling “sausage digits.”
Extra-articular manifestations: Conjunctivitis, which usually occurs 4-8 weeks after an infection of the genitourinary or digestive tract.
50-70% of patients have a history of infections in the genitourinary or digestive systems. About 20-30% of patients have a family history of spinal disorders, with ankylosing spondylitis being the most common.
Currently, there is no specific test to definitively diagnose reactive arthritis. Diagnosis is based on clinical criteria (peripheral arthritis, lower back pain, periarticular soft tissue inflammation, extra-articular manifestations…), blood sedimentation tests, pathogen identification, and patient history (history of genitourinary or digestive infections).
Reactive arthritis can self-limit and completely resolve without leaving complications if diagnosed and treated appropriately. However, in 10-20% of cases, the disease can progress chronically with multiple relapses (peripheral arthritis and periarticular inflammation), significantly affecting joint function and the quality of life of the patient.
The severity of reactive arthritis varies greatly, thus requiring a treatment strategy tailored to the specific clinical presentation.
Dr. Tran Thi Minh Hoa, Health & Life
